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Min Y, Wei X, Liu Z, Wei Z, Pei Y, Li R, Jin J, Su Y, Hu X, Peng X. Assessing the role of lipid-lowering therapy on multi-cancer prevention: A mendelian randomization study. Front Pharmacol 2023; 14:1109580. [PMID: 37153802 PMCID: PMC10154601 DOI: 10.3389/fphar.2023.1109580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/07/2023] [Indexed: 05/10/2023] Open
Abstract
Background: Statin use for cancer prevention has raised wide attention but the conclusions are still controversial. Whether statins use have exact causal effects on cancer prevention remains unclear. Methods: Based on the Genome-Wide Association Studies (GWAS) datasets from the large prospective UK Biobank and other consortium databases, two-sample mendelian randomization (MR) analysis was conducted to explore the causal effects of statins use on varied site-specific cancer risks. Five MR methods were applied to investigate the causality. The stability, heterogeneity, and pleiotropy of MR results were also evaluated. Results: The atorvastatin use could increase the risk of colorectal cancer (odd ratio (OR) = 1.041, p = 0.035 by fixed-effects inverse variance weighted (IVW) method (IVWFE), OR = 1.086, p = 0.005 by weighted median; OR = 1.101, p = 0.048 by weighted mode, respectively). According to the weighted median and weighted mode, atorvastatin could modestly decrease the risk of liver cell cancer (OR = 0.989, p = 0.049, and OR = 0.984, p = 0.004, respectively) and head and neck cancer (OR = 0.972, p = 0.020). Besides, rosuvastatin use could reduce the bile duct cancer risk by 5.2% via IVWEF method (OR = 0.948, p = 0.031). No significant causality was determined in simvastatin use and pan-cancers via the IVWFE or multiplicative random-effects IVW (IVWMRE) method if applicable (p > 0.05). There was no horizontal pleiotropy observed in the MR analysis and the leave-one-out analysis proved the stability of the results. Conclusion: The causalities between statin use and cancer risk were only observed in colorectal cancer and bile duct cancer in the European ancestry population. Future works are warranted to provide more robust evidence for supporting statin repurposing for cancer prevention.
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Affiliation(s)
- Yu Min
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Xiaoyuan Wei
- Cancer Center, and State Key Laboratory of Biotherapy, Department of Head and Neck Oncology, Department of Radiation Oncology, West China Hospital, Sichuan University, Sichuan, China
| | - Zheran Liu
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Zhigong Wei
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Yiyan Pei
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Ruidan Li
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Jing Jin
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Yongllin Su
- Department of Rehabilitation, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Xiaolin Hu
- West China School of Nursing, West China Hospital, Sichuan University, Sichuan, China
- *Correspondence: Xingchen Peng, ; Xiaolin Hu,
| | - Xingchen Peng
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Sichuan, China
- *Correspondence: Xingchen Peng, ; Xiaolin Hu,
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Zhao G, Ji Y, Ye Q, Ye X, Wo G, Chen X, Shao X, Tang J. Effect of statins use on risk and prognosis of breast cancer: a meta-analysis. Anticancer Drugs 2022; 33:e507-e518. [PMID: 34407042 DOI: 10.1097/cad.0000000000001151] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The findings regarding the association between statins use and breast cancer are inconsistent. Given the widely and long-term use of statins as first choice drug for dyslipidemia, we conducted this meta-analysis for better understanding the associations between statins use and the risk and prognosis of breast cancer. Articles regarding effect of statins use on risk, prognosis of breast cancer and published before January 2021 were searched in the following databases: Web of Science, PubMed, EMBASE, Medline and Google Scholar. Odds ratios (ORs)/relative risks (RRs) or hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed to generate a pooled effect size and 95% CI. The meta-analysis showed no significant association between statins use and risk of breast cancer (OR/RR = 1.02; 95% CI, 0.97-1.08; I2 = 76.1%; P < 0.001). The meta-analysis showed that statins use was associated with lower breast cancer recurrence, all-cause mortality and disease-specific mortality (breast cancer recurrence: HR = 0.75; 95% CI, 0.67-0.84; I2 = 31.7%; P = 0.154; all-cause mortality: HR = 0.82; 95% CI, 0.77-0.89; I2 = 67.5%; P < 0.001; and disease-specific mortality: HR = 0.82; 95% CI, 0.72-0.93; I2 = 83.6%; P < 0.001). Overall, in this report we demonstrated that the use of statins can improve the prognosis of breast cancer patients including lower risks of breast cancer recurrence, all-cause and cancer-specific mortality, though statins therapy may not have an impact on reducing the risk of breast cancer.
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Affiliation(s)
- Guodong Zhao
- Nanjing University of Chinese Medicine, Nanjing
- Department of General Surgery and Department of Oncology, Lianshui County People's Hospital, Huaian, Jiangsu, China
| | - Yanjun Ji
- Department of General Surgery and Department of Oncology, Lianshui County People's Hospital, Huaian, Jiangsu, China
| | - Qing Ye
- Department of General Surgery and Department of Oncology, Lianshui County People's Hospital, Huaian, Jiangsu, China
| | - Xin Ye
- Department of General Surgery and Department of Oncology, Lianshui County People's Hospital, Huaian, Jiangsu, China
| | - Guanqun Wo
- Nanjing University of Chinese Medicine, Nanjing
| | - Xi Chen
- Nanjing University of Chinese Medicine, Nanjing
| | - Xinyi Shao
- Nanjing University of Chinese Medicine, Nanjing
| | - Jinhai Tang
- Nanjing University of Chinese Medicine, Nanjing
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Islam MM, Yang HC, Nguyen PA, Poly TN, Huang CW, Kekade S, Khalfan AM, Debnath T, Li YCJ, Abdul SS. Exploring association between statin use and breast cancer risk: an updated meta-analysis. Arch Gynecol Obstet 2017; 296:1043-1053. [PMID: 28940025 DOI: 10.1007/s00404-017-4533-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/12/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE The benefits of statin treatment for preventing cardiac disease are well established. However, preclinical studies suggested that statins may influence mammary cancer growth, but the clinical evidence is still inconsistent. We, therefore, performed an updated meta-analysis to provide a precise estimate of the risk of breast cancer in individuals undergoing statin therapy. METHODS For this meta-analysis, we searched PubMed, the Cochrane Library, Web of Science, Embase, and CINAHL for published studies up to January 31, 2017. Articles were included if they (1) were published in English; (2) had an observational study design with individual-level exposure and outcome data, examined the effect of statin therapy, and reported the incidence of breast cancer; and (3) reported estimates of either the relative risk, odds ratios, or hazard ratios with 95% confidence intervals (CIs). We used random-effect models to pool the estimates. RESULTS Of 2754 unique abstracts, 39 were selected for full-text review, and 36 studies reporting on 121,399 patients met all inclusion criteria. The overall pooled risks of breast cancer in patients using statins were 0.94 (95% CI 0.86-1.03) in random-effect models with significant heterogeneity between estimates (I 2 = 83.79%, p = 0.0001). However, we also stratified by region, the duration of statin therapy, methodological design, statin properties, and individual stain use. CONCLUSIONS Our results suggest that there is no association between statin use and breast cancer risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.
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Affiliation(s)
- Md Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.,International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Hsuan-Chia Yang
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Phung-Anh Nguyen
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan
| | - Chih-Wei Huang
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Shwetambara Kekade
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.,International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | | | - Tonmoy Debnath
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chuan Jack Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.,International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | - Shabbir Syed Abdul
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan. .,International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan.
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Murakami R, Chen C, Lyu SY, Lin CE, Tzeng PC, Wang TF, Chang JC, Shieh YH, Chen IF, Huang SK, Lin HW. Lovastatin lowers the risk of breast cancer: a population-based study using logistic regression with a random effects model. SPRINGERPLUS 2016; 5:1932. [PMID: 27872797 PMCID: PMC5101241 DOI: 10.1186/s40064-016-3606-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/27/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Laboratory studies have demonstrated statin-induced apoptosis of cancer cells, including breast cancer cells, and evidence is accumulating on the mechanism of statin-induced apoptosis. However, despite numerous epidemiological studies, no consensus has been reached regarding the relationship between statin use and breast cancer risk. METHODS This retrospective case-control study enrolled 4332 breast cancer patients and 21,660 age-matched controls registered in the National Health Insurance program of Taiwan, which covers approximately 99% of the population. The study cases were women for whom a diagnosis of breast cancer (ICD-9-CM code 174.X) had been recorded in LHID2005 between January 1, 2004 and December 31, 2010. A logistic regression model was adjusted for potential confounding factors, including the level of urbanization, and the Charlson Comorbidity Index was applied to assess potential comorbidities. We also considered possible bias caused by random urbanization, because nutrition and lifestyle factors are related to breast cancer incidence. RESULTS Our results showed that lovastatin was associated with a lower risk of breast cancer (adjusted OR 0.596; 95% CI 0.497-0.714; p < 0.001), and atorvastatin exhibited a protective tendency against breast cancer (adjusted OR 0.887; 95% CI 0.776-1.013; p < 0.077). CONCLUSIONS Although no consensus has been established regarding the relationship between statin use and breast cancer risk, our study indicated that lovastatin is a potential chemopreventive agent against breast cancer. Further detailed research is warranted.
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Affiliation(s)
- Rimi Murakami
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chiehfeng Chen
- Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yu Lyu
- School of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ching-En Lin
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pei-Chuan Tzeng
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Feng Wang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Juei-Chin Chang
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ying-Hua Shieh
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - I-Fan Chen
- Graduate Institute of Management of Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Shihping Kevin Huang
- Institute of Management of Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Hui-Wen Lin
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Mathematics, Soochow University, 70 Linhsi Road, Shihlin, Taipei, Taiwan
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Altwairgi AK. Statins are potential anticancerous agents (review). Oncol Rep 2015; 33:1019-39. [PMID: 25607255 DOI: 10.3892/or.2015.3741] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/23/2014] [Indexed: 11/05/2022] Open
Abstract
Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), which is a rate-limiting enzyme in the mevalonate pathway. The pleiotropic effects of statins may be mediated by the inhibition of downstream products such as small GTP-binding proteins, Rho, Ras and Rac whose localization and function are dependent on isoprenylation. Preclinical studies of statins in different cancer cell lines and animal models showed antiproliferative, pro‑apoptotic and anti-invasive effects. Notably, statins showed targeted action in cancerous cell lines compared to normal cells. Previous studies have also shown the synergistic effects of statins with chemotherapeutic agents and radiotherapy. This effect of statins was also observed in chemotherapeutic-resistant tumors. Statins were reported to sensitize the cells to radiation by arresting them in the late G1 phase of the cell cycle. Similarly, population-based studies also demonstrated a chemopreventive and survival benefit of statins in various types of cancers. However, this benefit has yet to be proven in clinical trials. The inter-individual variation in response to statins may be contributed to many genetic and non-genetic factors, including single-nucleotide polymorphisms in HMGCR gene and the overexpression of heterogeneous nuclear ribonucleoprotein A1, which was reported to reduce HMGCR enzyme activity. However, more studies with large phase III randomized controlled trials in cancer patients should be conducted to establish the effect of stains in cancer prevention and treatment.
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Bonovas S, Lytras T, Sitaras NM. Statin use and breast cancer: do we need more evidence and what should this be? Expert Opin Drug Saf 2014; 13:271-5. [PMID: 24517162 DOI: 10.1517/14740338.2014.888806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) have been proved highly effective treatments for primary and secondary prevention of cardiovascular diseases. Despite widespread and long-term use of statins, there is still a debate concerning their association with cancer at various sites, including breast. As of today, the accumulated epidemiological evidence does not support the hypothesis that statin use affects the risk of developing breast cancer when taken at low doses for managing hypercholesterolemia. However, current evidence cannot exclude an increased risk of breast cancer with statin use in subsets of individuals, for example, the elderly. On the other hand, some studies show that statins might be useful to prevent recurrence and improve survival in patients already suffering from certain breast cancer types. They could also be combined with certain anticancer drugs and potentiate their effects, ameliorate their side effects or prevent the development of resistance. Further research is warranted to clarify these issues.
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Affiliation(s)
- Stefanos Bonovas
- University of Athens, School of Medicine, Department of Pharmacology , Athens , Greece
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