Researchers from the Sidney Kimmel Cancer Center—Jefferson Health, Rutgers Cancer Institute and others are suggesting that among high-risk prostate cancer patients (e.g. those with high PSA and Gleason scores of 8+) two commonly prescribed medications, including cholesterol-lowering statins and diabetes therapy metformin, may actually have anticancer effects. Before this research, it was difficult to determine which one of these contributes to fighting cancer the most as they are both typically prescribed together. The new research reveals that statins, alone or with metformin, increase survival in men with high-risk prostate cancer.
The recent study was led by Grace Lu Yao, PhD, associate director of Population Science with Sidney Kimmel Cancer Center—Jefferson Health, one of only eight NCI-designated cancer centers nationwide with a prostate cancer program of excellence as well as Xiang-Lin Tan with Rutgers Cancer Institute. Other authors were involved from a number of prominent institutions.
Yao and team utilized data from the Surveillance, Epidemiology and End Results (SEER-18) database linked with Medicare files to assess patients diagnosed with cancer from 2007 through 2011. Based on the 12,700 patients, the researchers observed that statins alone or in combination with metformin was significantly associated with reduced mortality from all causes. Drilling into the data, the observational investigators observed the median survival of 3.9 years in med who were on both metformin and statins; 3.6 with statins alone and 3.1 years with metformin alone.
36% Reduction in Risk of Death
Dr. Lu-Yao reported they observed via the data analysis that “with respect to prostate mortality, metformin plus statin was associated with a 36% reduction in risk of death followed by statins alone.” She emphasized, “Those taking metformin alone were relatively rare, and there was no significant association with all-cause mortality.”
Confirmation of Taiwanese Findings
This U.S.-based study aligned with the findings of a similar population-based cohort study using Taiwan National Health Insurance Research Data revealing that men who took atorvastatin, pravastatin, or rosuvastatin—but not lovastatin—demonstrated a reduction in mortality compared with non-users. These three statins are more effective at lowering triglycerides and low-density lipoprotein cholesterol and raising high-density lipoprotein cholesterol than other statins in patients with hypercholesterolemia.
Moving Forward: Clinical Trials
The data outcomes of the Jefferson Health-led study offer important insight for the design of future randomized clinical trials of statin for high-risk patients with prostate cancer. The authors believe that based on the evidence generated by this observational study, a well-designed clinical trial is warranted to investigate the roles of statins and combination statins/metformin to reduce the mortality of cancer of the prostate.
The study was covered by a National Cancer Institute (NCI) grant as well as a grant from the Biometrics Shared Resource of the Rutgers Cancer Institute of New Jersey and the Sidney Kimmel Cancer Center Support Grant.
Grace Lu Yao, PhD, associate director of Population Science with Sidney Kimmel Cancer Center—Jefferson Health
Xiang-Lin Tan with Rutgers Cancer Institute of New Jersey
For a list of all authors, see the published study in Cancer Medicine titled “Individual and Joint Effects of Metformin and Statins on Mortality among Patients with High-Risk Prostate Cancer.”
Call to Action: This research has important implications. Relatively low-cost, available medications could have an impact on high-risk conditions, such as prostate cancer. TrialSite News will monitor the group for forthcoming clinical trials centered on this hypothesis.