Are statins promising treatment for ovarian cancer? Study throws light
Delhi: The use of lipophilic statins among ovarian cancer patients may lead to a 40% reduction in cancer-specific mortality, according to a recent study. The study was presented at the second American Association for Cancer Research (AACR) virtual meeting.
Due to promising preclinical and epidemiologic data, modest toxicity, low cost, and broad access, repurposing statins for ovarian cancer treatment is appealing. To inform the design of a randomized clinical trial, Kala Visvanathan, Johns Hopkins Medicine, Baltimore, MD, and colleagues conducted a large observational study to identify subgroups of ovarian cancer (OC) patients that could benefit from statin treatment.
The researchers used data from the Finnish national cancer registry that was linked to prescription claims on 10,062 women with ovarian cancer. Then the researchers analyzed the association between pre- and post-diagnostic statin use and mortality. They used time updated marginal structural Cox regression models with inverse probability of treatment weights to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs) between users and never users to address potential confounding due to indication for statin initiation.
The median (IQR) age of diagnosis among patients was 63 (53-74) years, and median (IQR) follow up time was 4 (1.5-9.3) years. A total of 2,621 patients were statin users of which 80% took statins classified as lipophilic. The Median (IQR) duration of statin use was 7.5 (3.6-11.4) years.
Key findings of the study include:
- Eighty-two percent of statin users filled 90% of their prescriptions.
- In time updated models, ever use of statins was associated with a 40% reduction in OC mortality compared to never use (HR Overall = 0.60; HR Lipophilic = 0.78).
- The benefit from statin use was greater in those being treated with curative intent (HR=0.19) rather than palliative intent (HR =0.41).
- Reductions in OC mortality were also observed in women who primarily took one specific lipophilic statin: HR Atorvastatin= 0.35; and HR Simvastatin= 0.25).
- Among women taking lipophilic statins, a greater reduction in mortality was observed with increasing statin dose.
- Lipophilic statin use was also associated with a reduction in OC mortality among most OC subtypes, but the magnitude of reduction varied: High Grade Serous Carcinoma (HR= 0.43); Endometroid (HR =0.65); Clear cell (HR= 1.02); Mucinous (HR=0.60); and Borderline (HR =0.30).
- A reduction in OC mortality was also observed in analyses limited to women who initiated lipophilic statins post-diagnosis.
"Our results provide further evidence in support of the evaluation of lipophilic statins, particularly atorvastatin and/or simvastatin, for the treatment of OC in a randomized clinical trial," concluded the authors.
The study, "Lipophilic Statins show promise for treatment of epithelial ovarian cancer," was presented at the American Association for Cancer Research (AACR) virtual meeting 2020.