title: Influence of Statins on Survival Outcome in Patients with Metastatic Castration Resistant Prostate Cancer Treated with Abiraterone Acetate.
abstract: OBJECTIVE
  Even though the exact mechanism is largely unknown until now, statins are supposed to improve survival outcomes in various malignancies. For prostate cancer however, statins are known to compete with dehydroepiandrosterone (DHEAS) for the transport into the cytosol both using the cell by the Solute Carrier Transporter and thus diminish the cellular uptake of DHEAS as a precursor of androgens. Abiraterone inhibits CYP17A1 and thus effectively decreases the production of all relevant androgens including DHEAS. In this study we examined whether statins still affect survival outcome in patients with metastatic castration resistant prostate cancer (mCRPC) when treated with Abiraterone.
  
  
  METHODS
  108 men with mCRPC treated with Abiraterone from 02/2010 to 07/2015 with (n = 21) or without (n = 87) concomitant treatment with statins were investigated. Progression free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier-estimates and univariate Cox-regression analysis. The influence on best clinical benefit under Abiraterone treatment was analyzed with bivariate and multivariate logistic regression analysis.
  
  
  RESULTS
  PSA-decline ≥ 50% was not significantly different in both groups (57 vs. 53%; p = 0.73). The median PFS (9 vs. 10 months; p = 0.97) and OS (14 vs. 18 months; p = 0.77) did not differ significantly between those men treated with and without concomitant statin therapy, respectively. Accordingly, there was no improvement for best clinical benefit in patients using statins (odds ratio: 1.2 (CI: 0.4-4.2); p = 0.76).
  
  
  CONCLUSIONS
  Use of statins as concomitant medication did not improve survival outcomes or best clinical benefit in men with mCRPC treated with Abiraterone.
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Martin
authors: M
authors: Boegemann
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Katrin
authors: K
authors: Schlack
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Ann-Kathrin
authors: AK
authors: Fischer
authors: Institute of Biostatistics and Clinical Research of the Westfalian Wilhelms-University Muenster, Schmeddingstraße 56, D-48149 Muenster, Germany.
authors: Joachim
authors: J
authors: Gerß
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Julie
authors: J
authors: Steinestel
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Axel
authors: A
authors: Semjonow
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.
authors: Andres Jan
authors: AJ
authors: Schrader
authors: Department of Urology, Muenster University Medical Center, Muenster, Germany.|Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
authors: Laura-Maria
authors: LM
authors: Krabbe
mesh_terms: D000069501:Abiraterone Acetate / Q000627:therapeutic use*; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D016019:Survival Analysis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069501:Abiraterone Acetate