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Statin, metformin combination reduces prostate cancer mortality, particularly among obese men
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CHICAGO – The combined use of statins and metformin reduced disease-specific mortality in patients with prostate cancer, according to population-based study results presented at the ASCO Annual Meeting.
Patients with obesity and metabolic syndromes demonstrated particular efficacy from the combination, the researchers also found.
“A recent preclinical study showed that combined statin and metformin should have a synergistic effect to reduce metastasis [in patients with prostate cancer], and should be more effective than the standard chemotherapy regimen available,” Grace L. Lu-Yao, PhD, MPH, professor of medicine at Robert Wood Johnson Medical School and resident member of the Rutgers Cancer Institute of New Jersey, told HemOnc Today. “We conducted this study because there really is no clinical data out there.”
Grace L. Lu-Yao
Obesity and metabolic syndromes considerably increase the mortality risk among patients with prostate cancer, according to study background. Pre-clinical studies have suggested that the combination of statins and metformin inhibited metastasis with greater efficacy than standard docetaxel chemotherapy with less toxicity.
Lu-Yao and colleagues evaluated SEER–Medicare linked data to identify patients with high-risk prostate cancer — defined as stage III or IV, PSA greater than 20 or a Gleason score between 8 and 10 — between 2007 and 2009. Researchers also evaluated Medicare Part D Event files to ascertain prescription drug use.
The researchers used ICD-9 diagnosis codes 278, 278.01 or 277.7 to identify obesity and metabolic syndromes in patients.
The analysis included 22,110 men with high-risk prostate cancer, 1,365 of whom had died at the study cutoff date. Overall, 1,356 men used statins and metformin, 4,481 men used statins alone and 471 men used metformin alone.
Data indicated the use of combination statin and metformin therapy (n = 1,356) conferred a 43% reduction in disease-specific mortality compared with nonuse (HR = 0.57; 95% CI, 0.38-0.88).
Combination therapy also improved prostate cancer-specific mortality among men with obesity and metabolic syndromes (HR = 0.3; 95% CI, 0.07-1.27). Researchers reported similar results after limiting the analysis to patients with minimal comorbidities.
Researchers observed that the use of statins alone also conferred significant benefit in both the overall population (HR = 0.6; 95% CI, 0.47-0.76) and among men with obesity and metabolic syndromes (HR = 0.09; 95% CI, 0.01-0.64).
The researchers noted the need for further studies to confirm these findings.
“Our findings show a lot of promise,” Lu-Yao said. “We can reduce prostate cancer mortality by using this relatively safe, nontoxic drug. We need to learn more about who are likely to be the target population to benefit from this combination, along with the potency, timing and duration [of treatment]. Then we can launch a clinical trial to get the definitive answer.” – by Cameron Kelsall
Reference:
Lu-Yao GL, et al. Abstract 5018. Presented at: ASCO Annual Meeting; May 29-June 2, 2015; Chicago.
For more information:
Grace L. Lu-Yao, PhD, MPH, can be reached at Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ 08901; e-mail: luyaogr@cinj.rutgers.edu.
Disclosure: Lu-Yao reports employment and leadership roles with Sun Pharma and a consulting role with and stock ownership in Merck. One other researcher reports receiving research funding from Novartis.