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Atorvastatin Versus Placebo for Prostate Cancer Before Radical Prostatectomy-A Randomized, Double-blind, Placebo-controlled Clinical Trial.

Authors :
Murtola TJ
Syvälä H
Tolonen T
Helminen M
Riikonen J
Koskimäki J
Pakarainen T
Kaipia A
Isotalo T
Kujala P
Tammela TLJ
Source :
European urology [Eur Urol] 2018 Dec; Vol. 74 (6), pp. 697-701. Date of Electronic Publication: 2018 Jul 18.
Publication Year :
2018

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.)

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