Table 1.
Published studies evaluating associations between statin use and prostate cancer outcomes in the setting of ADT, ordered by proportion of primary ADT.
| First Author, ref. | Study setting | Study years | n | Statin users and type | ADT definition | Exposure | Outcome | Result |
|---|---|---|---|---|---|---|---|---|
| Murtola et al. [11] | Finnish Randomised Study of Screening for Prostate Cancer | 1996–2012 | 2649 ADT-treated patients; 617 deaths from prostate cancer over 7.5 years median follow-up | 3059 (47%) statin users; simvastatin (78%), atorvastatin (36%) | 17% primary ADT; ADT type not specified | Pre-diagnosis statin use (use vs. non-use) | Prostate cancer-specific mortality | HR 0.86; 95% CI 0.69–1.07 |
| Post-diagnosis statin use (time-dependent variable) | Prostate cancer-specific mortality | HR 0.74; 95% CI 0.59–0.94 | ||||||
| Peltomaa et al. [57] | Finnish Randomised Study of Screening for Prostate Cancer | 1996–2015 | 4428 ADT-treated patients; 834 deaths from prostate cancer and 1565 PSA relapses over 6.3 years median follow-up | 2544 (48%) statin users during follow-up period | 55% primary ADT; LHRH agonists/antagonists (81%), AAs (57%) and/or bilateral orchiectomy (9%) | Pre-ADT initiation statin use (use vs. non-use) | Prostate cancer-specific mortality | HR 1.12; 95% CI 0.96–1.31 |
| All-cause mortality | HR 1.13; 95% CI 1.02–1.25 | |||||||
| Post-ADT initiation statin use (time-dependent variable) | PSA relapse | HR 0.73; 95% CI 0.65–0.82 | ||||||
| Prostate cancer-specific mortality | HR 0.82; 95% CI 0.69–0.96 | |||||||
| All-cause mortality | HR 0.84; 95% CI 0.76–0.93 | |||||||
| Hamilton et al. [61] | Canadian Cancer Trials Group (CCTG) PR-7 trial of intermittent vs. continuous ADT in men with biochemical recurrence after radiotherapy | 1999–2005 | 1364 continous or intermittent ADT-treated patients; 513 deaths, 219 from prostate cancer over 6.9 years median follow-up | 287 (42%) statin users in intermittent ADT arm, 298 (44%) statin users in continuous ADT arm | 0% primary ADT; Continuous ADT arm: LHRH agonist combined with non-steroidal AA or orchiectomy; Intermittent ADT arm: LHRH agonist combined with non-steroidal AA | Statin use concurrent with ADT (time-dependent variable) | CRPC | HR 0.87; 95% CI 0.71–1.06 |
| Prostate cancer-specific mortality | HR 0.65; 95% CI 0.48–0.87 | |||||||
| All-cause mortality | HR 0.64; 95% CI 0.53–0.78 | |||||||
| Anderson-Carter et al. [63] | National US Veterans Administration database | 2000–2016 | 87,346 ADT-treated patients; 4 752 prostate cancer deaths; median follow-up not reported | 53,360 (61%) statin users | Men on short-term ADT (≤6 months) or using ADT in combination with radiation excluded, minimising number of men on primary ADT; LHRH agonists (Leuprolide, Goserelin), non-steroidal AAs (bicalutamide, flutamide and nilutamide) | Statin use concurrent with ADT (minimum 6 months use during study period vs. non-use) | Skeletal-related events (SREs) | HR 0.64; 95% CI 0.59–0.71 |
| Prostate cancer-specific mortality | HR 0.56; 95% CI 0.53–0.60 | |||||||
| All-cause mortality | HR 0.66; 95% CI 0.63–0.68 | |||||||
| Wu et al. [43] | Taiwan Cancer Registry | 2008–2014 | 5749 patients receiving ADT alone in first year after diagnosis; 2 259 deaths, 1495 from prostate cancer over an average of 3.6 years follow-up | 2171 (38%) statin users; 40% atorvastatin, 22% rosuvastatin, 12% simvastatin | Majority primary ADT; LHRH antagonists/agonists alone or in combination with AA | Post-diagnosis statin use (defined as anyone prescribed statins for >28 days; modelled as a time-dependant variable) | All-cause mortality | HR 0.75; 95% CI 0.68–0.82 |
| Prostate cancer-specific mortality | HR 0.77; 95% CI 0.69–0.86 | |||||||
| Harshman et al. [64] | US institutional clinical database | 1996–2013 | 926 ADT-treated patients with hormone sensitive prostate cancer; median follow-up of 5.8 years | 283 (31%) statin users at ADT initiation | 5% primary ADT; ADT type not specified | Statin use vs. non-use at ADT initiation | PSA relapse | HR 0.83; 95% CI 0.69–0.99 |
| Mikkelsen et al. [62] | Two Danish Urological Departments | 2007–2013 | 537 advanced or metastatic prostate cancer patients, primarily treated with ADT alone; 315 prostate cancer deaths over 5.7 years median follow-up | 141 (26%) statin users at time of diagnosis | 100% primary ADT; bilateral orchiectomy or LHRH agonists/antagonists | Statin use vs. non-use at diagnosis | Prostate cancer progression (CRPC or prostate cancer-specific mortality) | HR 0.98; 95% CI 0.72–1.32 |
| All-cause mortality | HR 1.11; 95% CI 0.82–1.50 |