Association Between Statin Exposure and Incidence and Prognosis of Prostate Cancer

Abstract

It is widely thought that statins have huge therapeutic potential against prostate cancer (PCA). This study aimed to investigate the effect of statin exposure on PCA incidence and prognosis. PubMed, Web of Science, Embase, and Cochrane databases were searched for observational studies on the association between statin exposure and PCA from inception until July 2022. The primary endpoints were the incidence of PCA and the survival rate. A total of 21 studies were included in this meta-analysis. The pooled estimates showed that exposure to hydrophilic statins was not associated with the incidence of PCA (odds ratio [OR] = 0.94, 95% CI = 0.88-1.01, P = 0.075), while the incidence of PCA was significantly decreased in populations exposed to lipophilic statins compared with the nonexposed group (OR = 0.94, 95% CI = 0.90-0.98, P = 0.001), mainly in Western countries (OR = 0.94, 95% CI = 0.91-0.98, P = 0.006). Subgroup analysis showed that simvastatin (OR = 0.83, 95% CI = 0.71-0.97, P = 0.016) effectively reduced the incidence of PCA. The prognosis of PCA in patients exposed to both hydrophilic (hazard ratio [HR] = 0.57, 95% CI = 0.49-0.66, P < 0.001) and lipophilic (HR = 0.65, 95% CI = 0.58-0.73, P < 0.001) statins were better than in the nonexposed group, and this improvement was more significant in the East than in Western countries. This study demonstrates that statins can reduce the incidence of PCA and improve prognosis, and are affected by population region and statin properties (hydrophilic and lipophilic).

Unraveling the intricate relationship between lipid metabolism and oncogenic signaling pathways

“…Statins hinder lipid metabolism and promote cell survival in different types of cancers, such as colon, pancreas, liver, breast, prostate, bladder, lung, and skin cancers ( Apostolova et al, 2016 ; Ahmadi et al, 2020 ). Statin use has been shown to lower the occurrence and reappearance of multiple types of cancer in 3129 human epidemiologic studies, including bladder, breast, colon, kidney, lung, skin, pancreatic, and prostate cancers ( Cauley et al, 2006 ; Cao et al, 2023 ; Takada et al, 2023 ; Wang et al, 2023 ; Zhang et al, 2024 ). Simvastatin, a cholesterol synthesis inhibitor, blocks the Akt pathway and induces apoptosis in prostate cancer cells ( Zhuang et al, 2005 ).…”