Chemotherapeutic Potential of Metformin and Statins to Prevent Progression to Lethal Prostate Cancer
Abstract
Although the overall survival rate in men with prostate cancer is high, the 5-year survival rate for men with prostate cancer that has metastasized distantly is only 30%. Traditional treatment for men with advanced prostate cancer is hormone therapy or chemotherapy; yet, both of these treatment options have significant side effects. Recent evidence has suggested that commonly used prescription medications, including metformin (to treat diabetes) and statins (to lower high cholesterol), are associated with a reduced risk of adverse prostate cancer outcomes such as death and recurrence. However, there is limited and inconsistent evidence about the potential impact of these medications among men with advanced prostate cancer. In this project, I propose to investigate the potential of metformin and statins to prevent progression to lethal prostate cancer, specifically in men who have been (1) diagnosed with metastatic disease or (2) have experienced a recurrence after diagnosis. The study population will consist of all U.S. Veterans diagnosed with prostate cancer at any Veteran’s Affair (VA) hospital between 1997-2009. This population is ideal for investigating these questions, as it is a nationally representative sample of prostate cancer patients that is large enough to specifically examine the sub-group of high-risk patients that are diagnosed with metastatic disease or experienced a recurrence. Moreover, about 27% of our study population will consist of African American men, allowing us to examine the impact of metformin and statins in those men most likely to suffer adverse prostate cancer outcomes. The results for this study will help identify whether metformin and statins can be used as an effective treatment option in men with advanced disease. Using the results of this study, we will be able to provide physicians with empirical evidence as to whether metformin and statins can improve survival in men with advanced prostate cancer. If we can demonstrate that metformin and statins are associated with increased survival in men, we will have identified a low-cost, low-toxicity alternative to current therapies. This has the potential to improve the quality of life of men that are diagnosed with advanced disease. Because metformin and statins are readily available, low-cost, and commonly prescribed medications, use of these medications as a potential treatment option in men with advanced prostate cancer could be implemented quickly and improve patient-related outcomes in the near future. As a cancer epidemiologist with a focus on prostate cancer research, my ultimate goal is to establish a research program that identifies risk factors for and reduces the burden of adverse prostate cancer outcomes in high-risk men. The proposed project directly works toward this goal by allowing me to investigate the treatment potential of commonly used medications to improve prostate cancer outcomes in a large, ethnically diverse cohort of U.S. Veterans. While I currently have a strong background in cancer epidemiology, this study will allow me to expand on these skills by building expertise in the underlying cardiovascular and endocrine diseases for which metformin and statins are taken, as well as the epidemiology of pharmaceuticals, and to expand my analytical skill set by working with large administrative data sets. With my mentors, I have established specific objectives to achieve these goals. These include taking a course in diabetes epidemiology, attending training seminars offered by the Veterans Health Administration pertaining to this project, such as “VA Pharmacy Data,” and attending relevant cancer epidemiology and urology conferences. Ultimately, this research development plan will ensure that I have a skill set that combines expertise in prostate cancer with expertise in cardiovascular and endocrine disease, along with pharmacoepidemiology, so that I can establish my career as a multidisciplinary prostate ca
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810168
Entities
People
- Saira Khan
Organizations
- United States Army
- Washington University in St. Louis