In search of the optimal setting for statin trials in prostate cancer: the power of population-based studies

Allott, Emma H.; Craig, Emma L; Stopsack, Konrad H.

doi:10.1038/s41391-021-00355-y

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…There are several theories regarding the cause for this association [ 24 ], but these medications are not routinely used for prostate cancer prevention. Recently, there has been renewed interest in exploring the role of statins and metformin in the prevention of prostate cancer development, progression, and death [ 25 , 26 ], and while these agents have considerable promise for the general population, their specific effectiveness in individuals with high-risk germline mutations has not been evaluated.…”

Section: Resultsmentioning

confidence: 99%

Clinical Management of Prostate Cancer in High-Risk Genetic Mutation Carriers

Clark

Herrera-Cáceres

Kenk

et al. 2022

Cancers

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Background: Prostate cancer is a leading cause of death. Approximately one in eight men who are diagnosed with prostate cancer will die of it. Since there is a large difference in mortality between low- and high-risk prostate cancers, it is critical to identify individuals who are at high-risk for disease progression and death. Germline genetic differences are increasingly recognized as contributing to risk of lethal prostate cancer. The objective of this paper is to review prostate cancer management options for men with high-risk germline mutations. Methods: We performed a review of the literature to identify articles regarding management of prostate cancer in individuals with high-risk germline genetic mutations. Results: We identified numerous publications regarding the management of prostate cancer among high-risk germline carriers, but the overall quality of the evidence is low. Conclusions: We performed a review of the literature and compiled clinical considerations for the management of individuals with high-risk germline mutations when they develop prostate cancer. The quality of the evidence is low, and there is an immediate need for further research and the development of consensus guidelines to guide clinical practice for these individuals.

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Section: Resultsmentioning

confidence: 99%

Clinical Management of Prostate Cancer in High-Risk Genetic Mutation Carriers

Clark

Herrera-Cáceres

Kenk

et al. 2022

Cancers

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Statins and prostate cancer—hype or hope? The epidemiological perspective

Craig

Stopsack

Evergren

et al. 2022

Prostate Cancer Prostatic Dis

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Background Men using cholesterol-lowering statin medications have been found to have lower risks of both advanced and fatal prostate cancer in multiple registry-based studies and prospective cohort studies. Statin use has also been associated with longer survival among men already diagnosed with prostate cancer. Mechanisms responsible for purported anti-cancer effects of statins are not well understood but may offer insight into prostate cancer biology. Methods We summarise epidemiological data from studies of statins and prostate cancer and discuss to what extent these findings can be interpreted as causal. Additionally, lipid-mediated and non-lipid-mediated mechanisms that may contribute to potential anti-cancer effects of statins are reviewed. Finally, we consider treatment settings and molecular subgroups of men who might benefit more than others from statin use in terms of prostate cancer-specific outcomes. Results Data from prospective observational studies generally reported a lower risk of fatal prostate cancer among statin users. There is some evidence for serum cholesterol-lowering as an indirect mechanism linking statins with advanced and fatal prostate cancer. Window-of-opportunity clinical trials show measurable levels of statins in prostate tissue highlighting potential for direct effects, whilst observational data suggest possible statin-driven modulation of prostate microenvironment inflammation. Additionally, emerging data from registry studies support a potential role for statins within the context of androgen deprivation therapy and anti-androgen treatment. Conclusion Prospective and registry-based studies support a lower risk of advanced and fatal prostate cancer in statin users relative to non-users, as well as better outcomes among prostate cancer patients. The few randomised-controlled trials conducted so far have short follow-up, lack identified molecular subgroups, and do not provide additional support for the observational results. Consequently, additional evidence is required to determine which men may experience greatest benefit in terms of prostate cancer-specific outcomes and how statin effects may vary according to molecular tumour characteristics.

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In search of the optimal setting for statin trials in prostate cancer: the power of population-based studies

Cited by 2 publications

References 10 publications

Clinical Management of Prostate Cancer in High-Risk Genetic Mutation Carriers

Clinical Management of Prostate Cancer in High-Risk Genetic Mutation Carriers

Statins and prostate cancer—hype or hope? The epidemiological perspective

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