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OVERALL SURVIVAL ON PATIENTS WITH METASTATIC CASTRATION RESISTANT PROSTATE CANCER USING STATINS COMBINED TO NEW ANTI-ANDROGEN THERAPIES: SYSTEMATIC REVIEW AND META-ANALYSIS
Introdução, Material, Método, Resultados, Discussão e Conclusões
INTRODUCTION: Statins have a well established effect in the treatment of dyslipidemia, but its use on patients with prostate cancer has been controversial. The use of these drugs suggests a possibility of synergism with active systemic treatments improving survival outcomes in advanced prostate cancer patients.
PURPOSE: To evaluate whether statin use affects overall survival in patients with metastatic castration-resistant prostate cancer treated with new anti-androgen therapies.
METHODS: We searched studies including the keywords statins, survival outcome, metastatic castration resistant prostate cancer on PubMed (MEDLINE), Embase and Cochrane databases.
RESULTS: A systematic review was performed according to PRISMA guidelines. A total of 195 articles were initially found, but only four studies with profiles corresponding to the selection criteria were included in the analysis. We obtained i2 value = 74% which indicates a highly significant heterogeneity between studies that cannot be explained by chance. The addition of statins to new anti-androgen therapies in metastatic castration-resistant prostate cancer was associated with longer overall survival in both univariate (HR = 0.63 [0.45; 0.87] p=0,07) and multi-variate analysis (HR = 0.54 [0.34; 0.87] p<0,01).
CONCLUSIONS: The use of statin associated with the new anti-androgen therapies demonstrated longer overall survival in patients with mCRPC. Within the articles evaluated some did not specify which statin was used, as well of prescribed doses, which raises the question whether these details could promote different results. Randomized controlled trials should be conducted to confirm these outcomes.
Statins, Survival Outcome, Metastatic Castration Resistant Prostate Cancer.
Câncer de Próstata Metastático
UNIFESP - Sao Paulo - Brasil
Renato Meirelles Mariano da Costa Junior, Kevin Lima Tavares, Renato Panhoca, Tiago Aparecida Silva, Vitor Bonadia Buonfiglio, Marcus Vinicius Sadi