The effect of statin use on survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with androgen receptor targeted therapies (ART).

Abstract

194 Background: Statins may reinforce and provide a compounded effect on ART by decreasing cholesterol levels thus decreasing de novo androgen synthesis. We aim to investigate the clinical effect of concurrent statin and ART use on outcomes of mCRPC patients. Methods: We conducted a retrospective analysis on mCRPC patients receiving ART from a single institution. Relevant demographic and clinical data was collected in addition to ART treatment course, statin treatment, and survival outcomes. Our primary outcome was PSA progression free survival (PFS) and our secondary outcomes were overall survival (OS) and associated prognostic factors for both PSA PFS and OS. Chi-squared test and Wilcoxon signed ranked test were used to compare baseline characteristics, and a Cox proportional hazards regression model was used to estimate hazard ratios (HR) with 95% confidence interval (CI) for overall survival (OS) and PSA PFS. Results: 153 patients were included in the analysis between 2010 and 2021. 67 patients (mean age 73.8 years) received concurrent statins and 86 patients (mean age 67.6 years) did not. Median PSA PFS was 37.4 months for patients that received concurrent statins and 17.4 months for patients that did not receive statins. On univariate and multivariate analyses, there was no statistically significance difference between groups for PSA PFS (HR 0.7; CI 0.44-1.1; p=0.122). Median OS was 35.6 months for patients that received concurrent statins and 24.0 months for patients who did not. There was no statistical significance between groups for OS on univariate or multivariate analyses (HR 0.67; CI 0.42-1.06; p=0.087). Conclusions: Although results were not statistically significant, our study illustrates that concurrent statin use exhibits improved time to PSA progression and OS in mCRPC patients. Larger multi-center and further prospective studies are warranted to elucidate the relationship between statin use and overall outcomes in this population.