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Atorvastatin Versus Placebo for Prostate Cancer Before Radical Prostatectomy-A Randomized, Double-blind, Placebo-controlled Clinical Trial.
- Source :
-
European urology [Eur Urol] 2018 Dec; Vol. 74 (6), pp. 697-701. Date of Electronic Publication: 2018 Jul 18. - Publication Year :
- 2018
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Abstract
- We tested whether intervention with atorvastatin affects the prostate beneficially compared with placebo in men with prostate cancer in a randomized clinical trial. A total of 160 statin-naïve prostate cancer patients scheduled for radical prostatectomy were randomized to use 80mg atorvastatin or placebo daily from recruitment to surgery for a median of 27 d. Blinding was maintained throughout the trial. In total, 158 men completed the follow-up, with 96% compliance. Overall, atorvastatin did not significantly lower tumor proliferation index Ki-67 or serum prostate-specific antigen (PSA) compared with placebo. In subgroup analyses, after a minimum of 28 d of atorvastatin use, Ki-67 was 14.1% lower compared with placebo (p = 0.056). Among high-grade cases (International Society of Urological Pathology Gleason grade 3 or higher), atorvastatin lowered PSA compared with placebo: median change -0.6 ng/ml; p = 0.024. Intraprostatic inflammation did not differ between the study arms (p = 0.8). Despite a negative overall result showing no effect of statins on Ki67 or PSA overall, in post hoc exploratory analyses, there appeared to be benefit after a minimum duration of 28 d. Further studies are needed to verify this. PATIENT SUMMARY: Cholesterol-lowering atorvastatin does not lower prostate cancer proliferation rate compared with placebo overall, but exploratory analyses suggest a benefit in longer exposure.<br /> (Copyright © 2018. Published by Elsevier B.V.)
- Subjects :
- Aged
Antineoplastic Agents adverse effects
Atorvastatin adverse effects
Cell Proliferation drug effects
Chemotherapy, Adjuvant
Double-Blind Method
Finland
Humans
Kallikreins blood
Ki-67 Antigen metabolism
Male
Middle Aged
Prostate-Specific Antigen blood
Prostatic Neoplasms blood
Prostatic Neoplasms pathology
Prostatic Neoplasms surgery
Time Factors
Treatment Outcome
Antineoplastic Agents administration & dosage
Atorvastatin administration & dosage
Neoadjuvant Therapy
Prostatectomy methods
Prostatic Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1873-7560
- Volume :
- 74
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European urology
- Publication Type :
- Report
- Accession number :
- 30031572
- Full Text :
- https://doi.org/10.1016/j.eururo.2018.06.037