Abstract
Background: Statin, a lipid-lowering drug, has been suggested to confer anticancer efficacy. However, previous studies evaluating the association between statin use and prognosis in breast cancer showed inconsistent results. A meta-analysis was performed to evaluate the association between statin use and clinical outcome in women with breast cancer.Methods: Cohort studies comparing recurrence or disease-specific mortality in women with breast cancer with and without using of statins were identified by search of PubMed, Embase, and Cochrane's Library databases. A random-effect model, incorporating the inter-study heterogeneity, was used to combine the results. Subgroup analyses were performed to evaluate the influences of study characteristics on the outcomesResults: Seventeen cohort studies with 168,700 women with breast cancer were included. Pooled results showed that statin use was significantly associated with a lower risk of breast cancer recurrence (adjusted hazard ratio [HR] = 0.72, p < 0.001) and breast cancer mortality (HR = 0.80, p < 0.001). Subgroup analysis showed that timing of statin use, statin type, study design, sample size, or quality score did not significantly affect the outcomes. However, statin use was associated with more remarkably reduced breast cancer recurrence in studies with mean follow-up duration ≤ 5 years (HR = 0.55, p < 0.001) than that in studies of >5 years (HR = 0.83, p = 0.01).Conclusions: Statin use is associated with reduced recurrence and disease-specific mortality in women with breast cancer. These results should be validated in randomized controlled trials.
Highlights
Advances have been achieved in the prevention and treatment of breast cancer in recent decades, the disease remains one of the most common malignancies in women [1, 2]
922 studies were obtained from database search, and 886 of them were excluded primarily because they were not relevant to the aim of the meta-analysis
Statin use was defined as statin exposure before, at, and after the diagnosis of breast cancer in different studies
Summary
Advances have been achieved in the prevention and treatment of breast cancer in recent decades, the disease remains one of the most common malignancies in women [1, 2]. Accumulating evidence revealed that statins have various potential pharmacological effects besides their lipid-lowering efficacy, such as anti-inflammation, anti-proliferation, and anti-invasion, pro-apoptosis, immunomodulation, which are all involved in the pathogenesis of cancer [6, 7]. These findings highlight the potential role of statins as anticancer agents [8]. Several meta-analyses have been performed to evaluate the association between statin use and prognosis in women with breast cancer [29,30,31,32], only studies published before 2017 were included, and the limited number of studies prevented a comprehensive evaluation of the impacts of study characteristics on the outcomes. A meta-analysis was performed to evaluate the association between statin use and clinical outcome in women with breast cancer
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