A study published by Nowakowska et al in the journal Cancer has found a significant association between the use of cholesterol-lowering statins and survival rates of patients with triple-negative breast cancer. Since statins are relatively inexpensive, easy to access, and produce minimal side effects, this may have an important impact on outcomes in this aggressive disease.
The study, led by Kevin Nead, MD, Assistant Professor of Epidemiology at The University of Texas MD Anderson Cancer Center, extends the current knowledge of the association between statin use and triple-negative breast cancer. It is reportedly the first study adequately powered to investigate the association of statins and aggressive breast cancer subtypes.
Study Methodology
The retrospective study selected patients included in the Surveillance, Epidemiology, and End Results (SEER)-Medicare registry and the Texas Cancer Registry (TCR)-Medicare, two large databases of administrative claims of Medicare-eligible patients. Patients were required to have Medicare Part D prescription coverage to determine their statin use.
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The research included data from 23,192 women older than age 66 with stage I to III breast cancer. From that patient cohort, 2,281 were incidental statin users, meaning they started a statin within 1 year of their breast cancer diagnosis. The incidental statin users were 78.1% White, 8.9% Black, 8.4% Hispanic, and 4.5% other.
Key Results
Researchers found a 58% relative improvement in breast cancer–specific survival and a 30% relative improvement in overall survival with statin use. The median follow-up was 3.3 years for breast cancer–specific survival and 4.4 years for overall survival.
“There is already a body of literature on statins and breast cancer, and the results have been inconsistent,” said Dr. Nead. “Previous research has looked at breast cancer as only one disease, but we know there are many subtypes of breast cancer, and we wanted to focus our research on this particularly aggressive form of breast cancer that has limited effective treatment options.”
Analysis by breast cancer stage suggested that the association of incidental statin use with improved outcomes may be stronger in women with early-stage triple-negative breast cancer. When examining statin intensity, high-intensity statin use had the strongest effect on overall survival among women with triple-negative breast cancer. Researchers also found a statistically significant association between lipophilic statins (eg, simvastatin, atorvastatin, lovastatin, fluvastatin, pitavastatin) and improved overall survival.
“We know that statins decrease breast cancer cell division and increase cell death,” Dr. Nead said. “Our study shows that there is an association between statins and improved outcomes in triple-negative breast cancer, and it is time to pursue this idea further in a prospective trial.”
Prospective trials are needed to validate these study results and to better define the potential role of statins in triple-negative breast cancer treatment.
Disclosure: This research was supported by the National Institutes of Health Cancer Center Support Grant, the Cancer Prevention Research Institute of Texas, and Komen. For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
