ASCO GU 2018: Impact Of Statins On Outcomes In Patients With mCRPC: COU-AA-301 and COU-AA-302 Trials

San Francisco, CA (UroToday.com) Retrospective database studies have suggested that statins may have a chemo-preventative impact on metastatic castrate resistant prostate cancer (mCRPC) pts treated with prednisone (P)/abiraterone (AA).

Methods:
The authors conducted a post-hoc analysis of individual patient data of mCRPC pts treated with AA and/or P on the randomized phase III clinical trials COU -AA-301 and COU-AA-302 in an attempt to analyze the impact of statins on overall survival (OS). This study, was carried out under YODA Project #2016-1136.

Results:
A total of 458 (41%) pre-chemotherapy pts and 348 (29%) post-chemotherapy pts were statins users. Improved OS was observed for mCPRC pts who were statins users in the post-docetaxel setting [HR: 0.82 (95% CI: 0.71 to 0.94); p = 0.006], and there was a trend towards a prolonged OS in the pre-docetaxel setting [HR: 0.89 (95% CI: 0.77 to 1.03); p = 0.13] adjusted by interventional treatment (AA and/or P). In the pre-docetaxel setting there were no significant differences in OS between the groups AA/P/non-statin users and placebo/P/statin users (p=0.3). In a multivariable analysis, patients randomized to AA/P who were statins users and presenting ECOG <2 had superior OS in the post-docetaxel setting. Similarly, age, ECOG and statin use were the strongest prognostic factors in the pre-docetaxel setting.

Conclusions:
This post-hoc analysis of two prospective randomized clinical trials demonstrated that statin use was associated with superior OS in mCPRC pts treated with P or AA/P. Further studies are needed to validate these results and perhaps guide on the use of statins as an adjunct to P and A.

Presented by: Guillermo de Velasco

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA
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