Pre-diagnostic statin use, lymph node status and mortality in women with stages I–III breast cancer

Abstract

Background:Recent meta-analyses suggest that pre-diagnostic statin use is associated with reduced breast cancer-specific mortality. Studies have shown that high breast tumour expression of the statin target (3-hydroxy-3-methylglutaryl coenzyme-A reductase) is associated with lymph-node negative cancer. Therefore, we examined the association between pre-diagnostic statin use and; lymph node status, breast cancer-specific and all-cause mortality.Methods:Women with stages I–III breast cancer were identified from the National Cancer Registry of Ireland (N=6314). Pre-diagnostic statin users were identified from linked prescription claims data (N=2082). Relative risks were estimated for associations between pre-diagnostic statin use and lymph node status. Hazard ratios (HR) were estimated for associations between pre-diagnostic statin use and breast cancer-specific and all-cause mortality.Results:Pre-diagnostic statin use was not associated with lymph node negative status at diagnosis. In multivariate analyses, pre-diagnostic statin use was associated with reduced all-cause (HR 0.78 95% confidence interval (CI) 0.69, 0.89) and breast cancer-specific mortality (HR 0.81 95% CI 0.68, 0.96). This reduction in cancer-specific mortality was greatest in statin-users with oestrogen (ER) receptor-positive tumours (HR 0.69 95% CI 0.55, 0.85).Conclusion:Patients with pre-diagnostic statin exposure had a significant reduction in breast cancer-specific mortality, which was even more pronounced in women with ER+ tumours.

Recycling the Purpose of Old Drugs to Treat Ovarian Cancer

“…In fact, for 13 types of cancers, it was observed a decrease in cancer-related death risk in statin users [ 61 ]. The anti-tumoral effects of statins has also been described in variety of other cancer origins, for example, endometrial cancer (HR = 0.83; 95% CI = 0.69–1.01) [ 58 ], breast cancer (HR = 0.81; 95% CI = 0.68–0.96) [ 64 ], colorectal cancer (fully adjusted HR = 0.71; 95% CI = 0.61–0.84) [ 65 ] and prostate cancer (HR = 0.76; 95% CI = 0.66–0.88) [ 66 ]. These studies show the effect of statins to prevent the onset of cancer.…”

Association Between Statin Use and Prognosis of Breast Cancer: A Meta-Analysis of Cohort Studies

“…The characteristics of the included cohorts were shown in Table 1 . Eight of them were prospective cohort studies ( 12 , 14 , 16 – 18 , 25 , 26 , 28 ), while the other nine were retrospective ( 13 , 15 , 19 – 23 , 25 , 27 ). Women with breast cancer of different clinical stages were included.…”

“…Meta-analysis of nine cohort studies ( 14 – 17 , 19 , 21 , 22 , 25 , 28 ) showed that statin use was associated with a significantly reduced risk of breast cancer mortality (adjusted HR = 0.80, 95% CI: 0.72 to 0.90; p < 0.001) with significant heterogeneity ( I 2 = 55%; Figure 4A ). Sensitivity analysis by omitting one study at a time showed similar results (HR: 0.79–0.86, p all <0.05).…”

“…Medians of the continuous variables were used as cut-off values for defining of subgroups. Because different cut-off values were applied in studies when analyzing the statin exposure time on the outcomes ( 16 , 18 , 20 , 21 , 25 , 27 ), we compared the HRs in subgroups with the shortest and the longest exposure time. Potential publication bias was assessed by visual inspection of the symmetry of the funnel plots and the Egger regression test ( 38 ).…”

Current state and outlook for drug repositioning anticipated in the field of ovarian cancer

“…These results caused researchers to pay attention to the antitumor effects of statins. After this study, antitumor effects were reported in similar epidemiological studies and basic research for other types of cancer, including colorectal cancer (fully adjusted HR=0.71; 95% CI=0.61–0.84) [23], prostate cancer (HR=0.76; 95% CI=0.66–0.88) [24], breast cancer (HR=0.81; 95% CI=0.68–0.96) [25], and endometrial cancer (HR=0.83; 95% CI=0.69–1.01) [26].…”