Combination of Statin/Vitamin D and Metastatic Castration-Resistant Prostate Cancer (CRPC) ...

[pjoshea13]

New study below [1].

Note: AA = Abiraterone acetate/Zytiga

"We conducted a post hoc analysis of individual patient data of CRPC patients treated with prednisone and/or AA with or without statins/vitamin D on randomized clinical trials."

"In the COU-AA-301 trial, use of AA with statin and vitamin D reduced the risk of death by 38% ... while AA alone was associated with a decrease of 10% .., compared to prednisone alone."

"... in the COU-AA-302 trial, use of AA plus statin plus vitamin D was associated with a reduced risk of death of 26% ..."

"In this data analysis from two prospective randomized clinical trials, statin and vitamin D use was associated with superior overall survival in metastatic CRPC patients treated with AA and prednisone."

-Patrick

pubmed.ncbi.nlm.nih.gov/321...

Clin Transl Oncol

2020 Mar 20[Online ahead of print]

Combination of Statin/Vitamin D and Metastatic Castration-Resistant Prostate Cancer (CRPC): A Post Hoc Analysis of Two Randomized Clinical Trials

A Carretero-González 1 , D Lora 2 , R Manneh 3 , D Lorente 4 , D Castellano 1 , G de Velasco 5

Affiliations collapse

Affiliations

1 Medical Oncology Department, University Hospital 12 de Octubre, Madrid, Spain.

2 Clinical Research Unit, IMAS12-CIBERESP, University Hospital 12 de Octubre, Madrid, Spain.

3 Oncology and Hematology Society From Cesar, Valledupar, Colombia.

4 Medical Oncology Department, Hospital Provincial de Castellón, Castellón de la Plana, Spain.

5 Medical Oncology Department, University Hospital 12 de Octubre, Madrid, Spain. [e-mail].

PMID: 32198642 DOI: 10.1007/s12094-020-02334-6

Abstract

In castration-resistant prostate cancer (CRPC) patients, observational studies have reported that statins may boost the antitumor activity of abiraterone (AA) and data suggest an improvement in efficacy; conclusions with vitamin D are less clear but an eventual benefit has been pointed. We conducted a post hoc analysis of individual patient data of CRPC patients treated with prednisone and/or AA with or without statins/vitamin D on randomized clinical trials. In the COU-AA-301 trial, use of AA with statin and vitamin D reduced the risk of death by 38% (p = 0.0007) while AA alone was associated with a decrease of 10% (p = 0.025), compared to prednisone alone. Meanwhile, in the COU-AA-302 trial, use of AA plus statin plus vitamin D was associated with a reduced risk of death of 26% (p = 0.0054). In this data analysis from two prospective randomized clinical trials, statin and vitamin D use was associated with superior overall survival in metastatic CRPC patients treated with AA and prednisone. To our knowledge, this is the first report suggesting the impact of statin plus vitamin D in this population. New strategies using big data may help to clarify these questions easily and in a most cost-effective approach.

Keywords: Abiraterone; Castration-resistant prostate cancer; Statins; Survival; Vitamin D.

[snoraste]

I wonder if it is the statin that carries the weight here.

[6357axbz]

I wonder if statin without vitamin D would have had the same effect?

[Proflac]

Thanks. What were the doses of statin and Vit D. I cant get the full text? One of the risks of AA is CVD - so I guess high statin might improve that?

[pjoshea13 in reply to Proflac]

I checked the trial papers & there is no mention of intervention arms. Looks like this is an an analysis using baseline personal data.

The doses would be all over the map.

Which implies that the results would have been better if (a) the maximum dosage had been used for the statins & (b) a minimum blood target had been attained for vitamin D users.

Even more reason to use them.

-Patrick

[Currumpaw]

Hey pjoshea13!

This doesn't apply to me, however, I must say that you are an excellent researcher or one who reads research and separates the "wheat from the chaff".

Thank you!

Currumpaw

[j-o-h-n in reply to Currumpaw]

And "foam from the beer".............

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/23/2020 5:24 PM DST