Intensive Cholesterol-Lowering and CD8+ T Cells in Prostate Cancer

This study investigates whether aggressively lowering cholesterol with a combination drug (Vytorin, which contains simvastatin and ezetimibe) can boost the immune system's ability to fight low-risk prostate cancer in men who are on active surveillance (watchful waiting rather than immediate treatment). **You may be eligible if...** - You have been diagnosed with low or intermediate-risk prostate cancer (PSA ≤ 20, Gleason score 3+3 to 4+3, stage T1c or T2) - You are on active surveillance with a biopsy planned - You have at least one cardiovascular risk factor (e.g., age ≥ 50, high blood pressure, high cholesterol, diabetes, BMI > 25, smoking history, family history of heart disease) - You have not had prior radiation, chemotherapy, or hormonal therapy for prostate cancer - You are able to take a daily oral medication **You may NOT be eligible if...** - You are on medications that interact with statins (such as certain antifungals or antibiotics) - You have a history of severe muscle pain from statin use - You have active liver disease or severe liver failure - You are already on the maximum statin dose or a PCSK9 inhibitor Talk to your doctor to see if this trial is right for you.