Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Oct;284(4):346-357.
doi: 10.1111/joim.12806. Epub 2018 Jul 9.

Statins: a role in breast cancer therapy?

S Borgquist  1   2 , O Bjarnadottir  2 , S Kimbung  2 , T P Ahern  3
Affiliations
Review

Statins: a role in breast cancer therapy?

S Borgquist et al. J Intern Med. 2018 Oct.

Abstract

Statin drugs have been used for more than two decades to treat hypercholesterolemia and as cardio-preventive drugs, resulting in a marked decrease in cardiovascular morbidity and mortality worldwide. Statins halt hepatic cholesterol biosynthesis by inhibiting the rate-limiting enzyme in the mevalonate pathway, hydroxymethylglutaryl-coenzyme A reductase (HMGCR). The mevalonate pathway regulates a host of biochemical processes in addition to cholesterol production. Attenuation of these pathways is likely responsible for the myriad benefits of statin therapy beyond cholesterol reduction - the so-called pleiotropic effects of statins. Chief amongst these purported effects is anti-cancer activity. A considerable body of preclinical, epidemiologic and clinical evidence shows that statins impair proliferation of breast cancer cells and reduce the risk of breast cancer recurrence. Potential mechanisms for this effect have been explored in laboratory models, but remain poorly understood and require further investigation. The number of clinical trials assessing the putative clinical benefit of statins in breast cancer is increasing. Currently, a total of 30 breast cancer/statin trials are listed at the global trial identifier website clinicaltrials.gov. Given the compelling evidence from performed trials in a variety of clinical settings, there have been calls for a clinical trial of statins in the adjuvant breast cancer setting. It would be imperative for such a trial to incorporate tumour biomarkers predictive of statin response in its design and analysis plan. Ongoing translational clinical trials aimed at biomarker discovery will help identify, which breast cancer patients are most likely to benefit from adjuvant statin therapy, and will add valuable clinical knowledge to the field.

Keywords: HMGCR; breast cancer; cholesterol; endocrine therapy; statins.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Pathways and potential predictive biomarkers that may mediate breast tumour response to statin therapy.
Figure 2
Figure 2
The prognostic value of statin treatment in the adjuvant breast cancer setting illustrated by a forest plot of the currently reported studies.
See this image and copyright information in PMC

References

    1. Ferlay J, Soerjomataram I, Dikshit R et al Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359–86. - PubMed
    1. Hauner D, Hauner H. Metabolic syndrome and breast cancer: is there a link? Breast Care (Basel) 2014; 9: 277–81. - PMC - PubMed
    1. Borgquist S, Jirstrom K, Anagnostaki L et al Anthropometric factors in relation to different tumor biological subgroups of postmenopausal breast cancer. Int J Cancer 2009; 124: 402–11. - PubMed
    1. Lahmann PH, Hoffmann K, Allen N et al Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC). Int J Cancer 2004; 111: 762–71. - PubMed
    1. Ewertz M, Jensen MB, Gunnarsdottir KA et al Effect of obesity on prognosis after early‐stage breast cancer. J Clin Oncol 2011; 29: 25–31. - PubMed

Publication types

MeSH terms

Substances