Statins and Abiraterone

[TommyTV]

Hi All

I really am in a quandary. I’ve read conflicting reports on statins. For the last 6+ years I’ve been taking Abiraterone/Prednisone and Zoladex with remarkable results, given my dx. I’m now considering adding a statin to help with cholesterol increase, and the earlier post regarding Simvastatin research producing good results has added to the positive side. However, I’m really reluctant to add another drug, as my current regime has worked so well. I don’t want to ‘upset the applecart’ so to speak.

My GP is not too clued up in the complexities of my drug trial, so he can’t persuade me either way.

Any thoughts on this that might help me decide?

Regards

Martin

[TenscTexan]

I’m very impressed to hear you’ve been on Zytiga for 6+ years. What is your current diagnosis? Are you mPC or mCRPC? I read back through your other posts and the one about the salt and vinegar chips during chemo was humorous. My savior was peanut m&m’s, but I didn’t get the results you did. I’ve been on Zytiga 2 months, getting tested in 2weeks, and I’d be happy getting a run on it half the time you’ve been on it. I wish I could help with the Simvastatin, I’m sure someone here will know.

[TommyTV in reply to TenscTexan]

Hi

Dx PSA was 571, seven Mets, Gleason 7. Within 8 weeks PSA was 0.2, four weeks later immeasurable where it’s been for the last 6 years and 5 months. Quite well apart from severe muscle loss, which combined with my damaged femurs has left me disabled. So what though,still enjoying life.

When I was first diagnosed I had a pretty rough time emotionally, caused by the poor life expectancy and ADT, however after around 4 years I’ve settled into a good rhythm.

I promised myself six years ago I’d do whatever it took to reach my 50th wedding anniversary, which was two weeks ago. Next is 70th birthday, then 75th birthday. I reckon the longer I live, the longer I’ll live, as new treatments become available.

Good luck with your journey, stay positive and enjoy everything in life to the fullest. (Except sex of course, that’s gone down the pan)😂.

[pjoshea13]

Martin,

Well, it would be foolish for me, or anyone, to ask "What could go wrong?"

But, your current strategy targets the androgen receptor, & a possible pathway to resistance involves the production of androgens from cholesterol, & even the synthesis of cholesterol itself. i.e. actually within the PCa cells.

Abi is a CYP17A1 inhibitor, so would block the well-known steroidogenesis routes - if it were to be taken up by PCa cells. But is it?

Abi aside, most solid tumors - not just PCa - over-accumulate cholesterol, & the extent that they do so correlates with poorer outcome. Without a biopsy, we can't know what the PCa cholesterol status is.

There are statin drug interactions, but I'm not aware of a Simvastatin interaction with Abiraterone or Prednisone.

Given the extent to which statins are prescribed (over-prescribed) in the U.S., a significant proportion of Abi users must have already been using a statin.

Just found a study [1]:

"we hypothesized that statins may compete with AA {Abiraterone acetate} for influx via SLCO2B1 and could negatively impact drug efficacy."

"Contrary to our initial hypothesis, there was a trend toward longer (rather than shorter) AA duration in statin users"

& another [2]:

"We assessed the effects of statin use in patients with advanced prostate cancer receiving abiraterone. Patients treated with a statin plus abiraterone appeared to live longer than those treated with abiraterone only. Since no negative drug-drug interaction is known and statins are widely used and inexpensive, further studies assessing the use of abiraterone plus statins are warranted.

& here is a neutral finding: [3].

Hope this helps.

-Patrick

[1] ncbi.nlm.nih.gov/pubmed/287...

[2] ncbi.nlm.nih.gov/pubmed/287...

[3] ncbi.nlm.nih.gov/pubmed/275...

[Spitzz]

VERY IMPRESSIVE on the 6+, it gives encouragement for me and others being on Zytiga, in my case 31 months. I know every case and everybody is different but I’ve been on Statins for years (lovastatin 20mg) before going on Zytiga without any noticeable side effects – BEST OF LUCK

[Break60]

Tommy

I was on a statin before dx with PCa and I’m still on it. My RO added metformin and cabergoline to ADT3 as well as estradiol, calcium and D3. They have worked well together.

Bob

[Apollo123]

Hi TommyTV

This is a question I have been wanting an answer to. I have discussed it with my oncologist who won’t commit to an answer! 👍