Cardio-Oncology Resource Center

Cardio-Oncology Resource Center

Disclosures: NIH, Cancer Prevention Research Institute of Texas and Susan G. Komen grants supported the study. Nead reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
September 15, 2021
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Statins may extend survival for certain women with triple-negative breast cancer

Disclosures: NIH, Cancer Prevention Research Institute of Texas and Susan G. Komen grants supported the study. Nead reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Use of statin therapy within the first year after breast cancer diagnosis appeared associated with a survival benefit among women with stage I to stage III triple-negative breast cancer, according to study results published in Cancer.

“There is a wealth of prior research on statins and breast cancer with inconsistent results. However, there was limited research on statins and the most aggressive forms of breast cancer, specifically triple-negative breast cancer,” Kevin T. Nead, MD, MPhil, researcher in the department of epidemiology and division of cancer prevention and population sciences at The University of Texas MD Anderson Cancer Center, told Healio. “We were interested in whether there was an association between starting statin therapy within the year following a diagnosis of breast cancer and improved survival among patients with triple-negative breast cancer.”

Use of statin therapy within the first year after breast cancer diagnosis appeared associated with a survival benefit among women with stage I to stage III triple-negative breast cancer.
Data derived from Nowakowska MK, et al. Cancer. 2021;doi:10.1002/cncr.33797.

Nead and colleagues used data from the SEER-Medicare and Texas Cancer Registry-Medicare databases between 2008 and 2015 to retrospectively evaluate 23,192 women aged 66 years and older with stage I to stage III breast cancer.

Approximately three-quarters (78.1%; n = 2,281) of women included in the study had initiated statin therapy within 1 year after diagnosis.

Researchers used multivariable Cox proportional hazards regression models to assess the association of new statin therapy use within 1 year after breast cancer diagnosis with OS and breast cancer-specific survival.

Median follow-up was 4.4 years (range, 1-10) for OS and 3.3 years (range, 0.1-8) for breast cancer-specific survival.

Nead and colleagues observed a significant association between incident statin use and improvements in breast cancer-specific survival (standardized HR [sHR] = 0.42; 95% CI, 0.2-0.88) and OS (HR = 0.7; 95% CI, 0.5-0.99) among women with triple-negative breast cancer (n = 1,534).

Conversely, results showed no association of statin use with breast cancer-specific survival (sHR = 0.99; 95% CI, 0.71-1.39) or OS (HR = 1.04; 95% CI, 0.92-1.17) among women with other breast cancer subtypes (n = 15,979).

Researchers also found a significant association specifically between lipophilic statin use and improvements in OS (HR = 0.66; 95% CI, 0.45-0.97) — with a directionally consistent impact on breast cancer-specific survival (sHR = 0.5; 95% CI, 0.24-1.07) — among women with triple-negative breast cancer. High-intensity statin therapy appeared to have the greatest effect on OS among the triple-negative breast cancer group (HR = 0.25; 95% CI, 0.06-1.01), but insufficient events occurred to examine breast cancer-specific survival in this subset.

Kevin T. Nead, MD, MPhil
Kevin T. Nead

“The large magnitude of improved survival for patients starting a statin within 1 year of diagnosis was surprising,” Nead said. “The basic science and observational data make a robust case that statins could benefit patients with triple-negative breast cancer. The combination of more limited effective treatment options for triple-negative breast cancer and the low toxicity profile of statin therapy makes the potential use of statins as an adjuvant therapy in triple-negative breast cancer a compelling research question we should continue to pursue.

“The next step is to verify our findings using a similar study design in a comparable data set,” Nead added “If the results hold up, a reasonable next step is to pursue a clinical trial to formally test whether starting statin therapy within the year after diagnosis of triple-negative breast cancer improves patient outcomes.”

For more information:

Kevin T. Nead, MD, MPhil, can be reached at The University of Texas MD Anderson Cancer Center, 1515 Pressler St., Office CPB4.3275, Houston, TX 77030; email: ktnead@mdanderson.org.