Statin use and survival outcomes in endocrine-related gynecologic cancers: A systematic review and meta-analysis

Abstract

Previous studies investigating the association between statin use and survival outcomes in gynecologic cancers have yielded controversial results. We conducted a systematic review and meta-analysis to evaluate the association based on available evidence. We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and PubMed from inception to January 2017. Studies that evaluated the association between statin use and survival outcomes in gynecologic cancers were included. Pooled hazard ratios (HRs) for overall survival, disease-specific survival and progression-free survival were calculated using a fixed-effects model. A total of 11 studies involving more than 6,920 patients with endocrine-related gynecologic cancers were identified. In a meta-analysis of 7 studies involving 5,449 patients with endocrine-related gynecologic cancers, statin use was linked to improved overall survival (HR, 0.71; 95% confidence interval [CI], 0.63 to 0.80) without significant heterogeneity (I2 = 33.3%). Statin users also had improved disease-specific survival (3 studies, HR, 0.72; 95% CI, 0.58 to 0.90, I2 = 35.1%) and progression-free survival (3 studies, HR, 0.68; 95% CI, 0.49 to 0.93, I2 = 33.6%) in endocrine-related gynecologic cancers. Our findings support that statin use has potential survival benefits for patients with endocrine-related gynecologic cancers. Further large-scale prospective studies are required to validate our findings.

Changes in mRNA/protein expression and signaling pathways in in vivo passaged mouse ovarian cancer cells

“…Lipids, including cholesterol and fatty acids, have been shown to play tumor-promoting roles in many cancers, including EOC [ 48 – 50 ]. Statins have been used in the management of several cancers [ 51 , 52 ] Statins target HMG-CoA reductase (Hmgcr), which is the rate-limiting enzyme for cholesterol synthesis. However, data exist showing that statins may have negative impacts in cancer treatment.…”

Recycling the Purpose of Old Drugs to Treat Ovarian Cancer

“…Regarding OC survival studies, the overall survival (OS) rate for post diagnostic patients is significantly higher in statins users (hazard ratio (HR)) = 0.63; 95% confidence interval (CI) = 0.54–0.74 [ 58 ]; HR = 0.87; 95% CI = 0.80–0.95 [ 59 ]) compared to non-users. Other studies show that statin users present all-cause mortality and cancer-related mortality rates significantly lower (HR = 0.72; 95% CI = 0.56–0.93 [ 60 ]; HR = 0.85; 95% CI = 0.82–0.87 [ 61 ]) compared to non-users.…”

“…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.…”

Do statins play role in reducing the incidence and mortality of ovarian cancer? A systematic review and meta-analysis

“…Other meta-analyses and review articles on gynecological cancers, such as breast and endometrial, have demonstrated that statin consumption generally has substantial survival-related benefits in terms of both disease-specific survival and overall survival, contributing to both pre- and post-diagnosis statin consumption [ 48-50 ]. Other meta-analyses have suggested that statin consumption is associated with an increase in survival for lung cancer [ 50 ], esophageal cancer [ 51 ], pancreatic cancer [ 52 , 53 ] and endocrine-related gynecologic cancers [ 54 ].…”