Impact of statin use on outcomes with apalutamide for advanced prostate cancer in TITAN and SPARTAN

The phase 3 TITAN trial included patients with metastatic hormone-sensitive prostate cancer and the phase 3 SPARTAN trial included patients with nonmetastatic castration-resistant prostate cancer. In both studies, patients were randomized to androgen deprivation therapy with or without apalutamide. Among the patients in the apalutamide arms, exposure to statins was associated with superior overall survival, which was not seen in the placebo arms. Patients receiving statins had a higher risk of grade 3 or greater cardiac adverse events, possibly reflecting their preexisting cardiovascular comorbidity. The authors conclude that these findings suggest a possible role of statin exposure in patients with advanced prostate cancer treated with androgen blockade.