Metabolic Syndrome and its Pharmacologic Treatment Associated with Progression to Castration-Resistant Prostate Cancer

Metabolic syndrome may be a risk factor for progression to castration-resistant prostate cancer (CRPC), according to a study published in Prostate Cancer and Prostatic Diseases.

“Metabolic syndrome and its pharmacologic treatment can potentially influence the progression of prostate cancer in men receiving androgen deprivation therapy (ADT),” the researchers wrote. Therefore, they aimed to assess the link between metabolic syndrome and its pharmacologic treatment with time to progression to CRPC.

This study consisted of 409 men with metastatic castration-sensitive prostate cancer who received their first line ADT from 1996 to 2014. Researchers collated data on metabolic syndrome, statin use, aspirin use, and metformin use at initiation of ADT from medical records. Time to CRPC was defined as the duration between initiating ADT and diagnosis of CRPC based on the Prostate Cancer Working Group 3 definition. Flexible parametric survival models were used to discern the association between metabolic conditions and time from ADT initiation to CRPC.

The results showed that following a median follow-up of 59 months, the majority of men (87%) progressed to CRPC, with a median time to CRPC of 19 months. After controlling for demographic and prostate cancer-specific variables, the results showed that metabolic syndrome was associated with shorter time to CRPC (hazard ratio [HR] = 1.41, 95% confidence interval [CI] 1.09-1.81). Importantly, the researchers noted, in men with metabolic syndrome, statin use was associated with a slower progression to CRPC (HR = 0.70, 95% CI 0.49-0.98).

“Our study suggests that metabolic syndrome is a risk factor for earlier progression from castration-sensitive to castration-resistant prostate cancer and raises the possibility that treatment, such as statin use, may slow the time to progression,” the researchers concluded.