The Suggested Unique Association Between the Various Statin Subgroups and Prostate Cancer

Goldberg, Hanan; Mohsin, F.; Saskin, Refik; Kulkarni, Girish S.; Berlín, Alejandro; Kenk, Miran; Wallis, Christopher J.D.; Klaassen, Zachary; Chandrasekar, Thenappan; Ahmad, Ardalan E.; Sayyid, Rashid K.; Saarela, Olli; Penn, L. J. Z.; Alibhai, Shabbir M.H.; Fleshner, Neil

doi:10.1016/j.euf.2020.06.005

Cited by 14 publications

(17 citation statements)

References 40 publications

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“…[ 16 17 18 ] In contrast, hydrophilic statins appear to be superior to lipophilic statins in the case of prostate cancer. [ 19 ] Our data, which were inclusive of several different types of cancer, found that hydrophilic statins may have superior anticancer effects.…”

Section: Discussionmentioning

confidence: 98%

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

et al. 2021

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Objective: Type 2 diabetes mellitus (T2DM) affects 10% of Americans and is associated with an increased incidence of cancer. Statins are first-line cholesterol-lowering medications in the treatment of hyperlipidemia. Several studies have demonstrated a relationship between statin use and reduced cancer incidence. We examined the cancer benefits of statin subtypes, with specific attention to disease-free survival (DFS) and overall survival (OS). Methods: This retrospective review included adults with T2DM diagnosed with solid tumors at Roswell Park Cancer Institute in Buffalo, NY, USA (2003–2010). Individuals with gestational diabetes, incomplete records, or diagnosed with rare solid tumors were excluded. Follow-up began at the date of diagnosis and ended with the first confirmed recurrence, death, or loss of contact. Demographics were assessed by Chi-square, Kaplan–Meier survival analyses, and Cox proportional hazards regression. Findings: Overall, 1102 patients met inclusion criteria, 52.1% of the study participants were female, and 578 participants (52.5%) died during the follow-up period which ranged from 0 to 156 months. Hydrophilic statin use was associated with improved DFS at 5-year follow-up (41.0% vs. 36.9%, P = 0.0077) compared to lipophilic statin use. Multivariate regression revealed that hydrophilic statins were associated with improved DFS (hazard ratio [HR]: 0.706, 95% confidence interval [CI]: 0.526–0.947) and OS (HR: 0.685, 95% CI: 0.503–0.934). Pravastatin was associated with improved OS (HR: 0.674, 95% CI: 0.471–0.964). Conclusion: In patients with T2DM and cancer, hydrophilic statins, and pravastatin in particular, are associated with improved DFS as well as OS. Further research examining the cancer-specific effects of hydrophilic and lipophilic statins is needed to better understand their beneficial effects.

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Section: Discussionmentioning

confidence: 98%

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

et al. 2021

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“…The study was reported according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines 20 and Reporting of Studies Conducted Using Observational Routinely-Collected Health Data statement 21 . We assembled a cohort of men aged 66 or above in Ontario, Canada, with a history of a single negative PB and no prior use of any of several various putative PCa chemopreventative medications as part of our original analysis 19 . As previously mentioned, we utilized the administrative data housed at the Institute for Clinical and Evaluative Sciences (ICES) with the primary intent of assessing the extent of the chemopreventative effect of these medications in PCa 19 .…”

Section: Methodsmentioning

confidence: 99%

“…We assembled a cohort of men aged 66 or above in Ontario, Canada, with a history of a single negative PB and no prior use of any of several various putative PCa chemopreventative medications as part of our original analysis 19 . As previously mentioned, we utilized the administrative data housed at the Institute for Clinical and Evaluative Sciences (ICES) with the primary intent of assessing the extent of the chemopreventative effect of these medications in PCa 19 . However, for this specific secondary study, our goal was to assess the associations of the various subgroups of statins with UR and LUTS within 30 days of a PB.…”

Section: Methodsmentioning

confidence: 99%

“…Our original study was to investigate the role of different statin subgroups in prostate cancer (PCa) chemoprevention in men who have had a single negative PB. This recently published analysis showed a beneficial role specifically for hydrophilic statins, but not for hydrophobic statins 19 . In this secondary study, we aimed to analyze whether any difference exists between hydrophilic and hydrophobic statins with UR rates and LUTS within 30 days of a PB, while adjusting for other commonly prescribed medications and baseline clinical factors.…”

Section: Introductionmentioning

confidence: 90%

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The association of statin subgroups with lower urinary tract symptoms following a prostate biopsy

Goldberg

Mohsin²,

Chandrasekar³

et al. 2021

CUAJ

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Introduction: This was a secondary analysis aiming to assess whether hydrophilic or hydrophobic statins have a differential effect on urinary retention (UR) and lower urinary tract symptoms (LUTS) in men following a prostate biopsy (PB), who were at risk for prostate cancer development. Methods: This was a population-based cohort study with data incorporated from the Institute for Clinical and Evaluative Sciences database to identify all Ontarian men aged 66 and above with a history of a single negative PB between 1994 and 2016, with no drug prescription history of any of several putative chemopreventative medications (statins, proton pump inhibitors, five-alpha-reductase inhibitors, and alpha-blockers). Multivariable Cox regression models with time-dependent covariates were used to assess the association of hydrophilic and hydrophobic statins with UR and LUTS within 30 days of a PB. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year. Results: Overall, 21 512 men were included, with a median followup time of 9.4 years (interquartile range [IQR] 5.4–13.4 years). Hydrophobic and hydrophilic statins were initiated by 30.7% and 19.6% of men, respectively, after the first negative PB. UR and LUTS were experienced by 2.2% and 10% of men, respectively. Cox models demonstrated hydrophilic statins were associated with a lower risk of UR (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.38–0.83, p=0.0038) and LUTS (HR 0.86, 95% CI 0.76–0.98, p=0.022), while no such association was shown for hydrophobic statins. Conclusions: Initiation of hydrophilic statins in men older than 66 appears to be inversely associated with the risk of UR and LUTS within 30 days of a PB.

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“…Another study in 2018 focused on the effects of omega-3 fatty acids in the diet on prostate cancer tumor progression in mice and concluded that its use can inhibit the growth and development of tumor cells [ 3 ]. However, such associations have not been consistently observed among different studies, and a causative association was not fully established nor its mechanism uncovered [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. These intriguing associations are complex and controversial, drawing active research for further elucidation.…”

Section: Introductionmentioning

confidence: 99%

Associations between Statin/Omega3 Usage and MRI-Based Radiomics Signatures in Prostate Cancer

Shi

Wahle

et al. 2021

Diagnostics

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Prostate cancer is the most common noncutaneous cancer and the second leading cause of cancer deaths among American men. Statins and omega-3 are two medications recently found to correlate with prostate cancer risk and aggressiveness, but the observed associations are complex and controversial. We therefore explore the novel application of radiomics in studying statin and omega-3 usage in prostate cancer patients. On MRIs of 91 prostate cancer patients, two regions of interest (ROIs), the whole prostate and the peripheral region of the prostate, were manually segmented. From each ROI, 944 radiomic features were extracted after field bias correction and normalization. Heatmaps were generated to study the radiomic feature patterns against statin or omega-3 usage. Radiomics models were trained on selected features and evaluated with 500-round threefold cross-validation for each drug/ROI combination. On the 1500 validation datasets, the radiomics model achieved average AUCs of 0.70, 0.74, 0.78, and 0.72 for omega-3/prostate, omega-3/peripheral, statin/prostate, and statin/peripheral, respectively. As the first study to analyze radiomics in relation to statin and omega-3 uses in prostate cancer patients, our study preliminarily established the existence of imaging-identifiable tissue-level changes in the prostate and illustrated the potential usefulness of radiomics for further exploring these medications’ effects and mechanisms in prostate cancer.

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The Suggested Unique Association Between the Various Statin Subgroups and Prostate Cancer

Cited by 14 publications

References 40 publications

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

Statin type and cancer outcomes in patients with diabetes type 2 and solid tumors

The association of statin subgroups with lower urinary tract symptoms following a prostate biopsy

Associations between Statin/Omega3 Usage and MRI-Based Radiomics Signatures in Prostate Cancer

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