<p>Statin and metformin therapy in prostate cancer patients with hyperlipidemia who underwent radiotherapy: a population-based cohort study</p>

Abstract

PurposeTo evaluate the association between the use of statins and/or metformin and patient survival in prostate cancer patients in Taiwan.Subjects and methodsNewly diagnosed prostate cancer patients who had hyperlipidemia and received radiotherapy were identified from the National Health Insurance Research Database 2000–2010. The survival rate was estimated by the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were performed to examine the association of mortality. Sensitivity analysis was performed to assess the risk of mortality in patients with diabetes.ResultsThe study included 567 patients. Patients who used statins or metformin after prostate cancer diagnosis had longer average survival times (9.3 years and 8.1 years, respectively; P=0.001) compared with patients who persistently used or used the medicines prior to cancer diagnosis. Multivariate Cox regression analysis found that patients treated with statins after cancer diagnosis were significantly associated with a lower risk of mortality (aHR =0.24, 95% CI =0.09–0.66) compared to patients who did not use statins during the study period. Patients treated with metformin after cancer diagnosis were significantly associated more with an increased risk of mortality (aHR =6.78, 95% CI =2.45–18.77) compared to patients who did not use metformin during the study period. Sensitivity analysis revealed that the average survival time was similar among different medicine use groups in patients with diabetes.ConclusionThe finding suggests that statins and metformin use after prostate cancer diagnosis may increase survival in patients with hyperlipidemia and radiotherapy.

Inhibition of EZH2 Enhances the Antitumor Efficacy of Metformin in Prostate Cancer

“…Moreover, a phase II trial observed prostate-specific antigen (PSA) secretion was decreased by the use of a high-dose metformin in progressive metastatic CRPC (9). Recently, a population-based cohort study showed encouraging results that metformin use after diagnosis of PCa might increase survival of patients (10). All of these suggest that metformin could be a useful medication for PCa therapy, but more studies are still needed to further evaluate such a notion.…”

The Effects of Statins on Prostate Cancer Patients Receiving Androgen Deprivation Therapy or Definitive Therapy: A Systematic Review and Meta-Analysis

“…In addition, studies that were not relevant to assessing the effects of statin use among PCa patients or had no extractable outcome data, as well as commentaries, conference abstracts, editorials, and reviews, were excluded. Finally, 12 studies met the inclusion criteria for the current meta-analysis [8,9,[23][24][25][26][27][28][29][30][31][32]. Six studies investigated the effects of statin use in PCa patients using ADT as their primary treatment [23][24][25][26][27][28].…”

“…Six studies investigated the effects of statin use in PCa patients using ADT as their primary treatment [23][24][25][26][27][28]. The other six studies investigated the effects of statin use in PCa patients using definitive therapy as their primary treatment [8,9,[29][30][31][32].…”

“…All six studies had a median of at least 3.5 years of follow-up. One study reported both all-cause mortality and cancer-specific mortality [29], three reported only all-cause mortality [8,31,32], and two reported only cancer-specific mortality [9,30].…”

“…Four studies compared all-cause mortality in PCa patients receiving definitive therapy as their primary treatment [8,29,31,32]. One of the studies (by Keskivali et al) separately reported statin use before and after a prostatectomy [29].…”