Clinical Trial Details
T-reg Function Changes: a Novel Immune Regulatory Effect Underlying Benefit of Statin Use on Lethal Prostate Cancer
Overview
This study will evaluate whether simvastatin reduces intraprostatic immunosuppressive microenvironment through YAP-mediated T-reg dysfunction, and increases intraprostatic anti-tumor immune response in men recently diagnosed with localized prostate cancer electing to receive prostatectomy for their care. Half the men will be randomized to receive statins for 8 weeks prior to their surgery, while the other half will receive standard of care.
Eligibility
| Ages | 18 Years and older |
| Sex | Male |
| Healthy Volunteers | No |
| Age Groups | Adult, Older Adult |
Inclusion Criteria:
- Men with pathologically-confirmed localized prostate cancer determined to be intermediate (stage T2b, or Gleason 7, or PSA 10-20 ng/mL) or high risk (stage T2c, or PSA >/=20 ng/mL, or Gleason >/=8) of biochemical recurrence at the time of biopsy
- Electing to undergo prostatectomy;
- Ability to provide written informed consent and willing to complete study procedures.
Exclusion Criteria:
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Current statin use or use of non-statin lipid-lowering drug (fibrates, bile acid sequestrants, or niacin);
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Current use of medications contraindicated for concomitant use with 40mg simvastatin:
- Gemfibrozil
- Cyclosporine
- Danazol
- CYP3A4 inhibitors: itraconazole; ketoconazole; posaconazole; erythromycin; clarithromycin; telithromycin; HIV protease inhibitors; boceprevir; telaprevir; nefazodone
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Current use of medications requiring lower dose of simvastatin not already listed as exclusions criteria:
- Verapamil
- Diltiazem
- Amiodarone
- Ranolazine
- Calcium channel blockers: verapamil; diltiazem; amlodipine
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Men with low-density lipoprotein cholesterol <50mg/dL
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Statin use in the previous 12 months;
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Discontinued statin use because of statin-related adverse event;
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Evidence or suspicion of metastases;
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Prior neoadjuvant or adjuvant chemotherapy, hormone therapy, or radiation therapy;
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History of non-prostate cancer other than non-melanoma skin cancer in the last 24 months;
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Diagnosed diabetes or currently taking diabetes medications
-
Prior myocardial infarction or stroke
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Chronic liver disease (hepatitis or cirrhosis) or abnormal liver function (>1.5x clinical laboratory's upper limit of normal alanine aminotransferase);
-
Stage 4 or 5 chronic kidney disease (Creatinine clearance / estimated glomerular filtration rate < 30 mL/min calculated by Cockgroft-Gault formula);
-
History of myopathy or inflammatory muscle disease (>3x clinical laboratory's upper limit of normal creatine kinase).
