Abstract
Background and purpose: Cholesterol-lowering drugs (statins) appear to have pleiotropic effects independent of cholesterol level. The aim of this study was to assess the effect of pre-operative therapy with a statin (atorvastatin) on tumor proliferation in patients with newly diagnosed breast cancer. Methods: Thirty cases with histologically proven breast cancer were subjected to treatment by atorvastatin 80 mg /day for at least 14 days before the final surgical procedure (MRM or BCS). Immunohistochemical expression of Ki-67 staining of breast tumor cells was evaluated to assess tumor proliferation in biopsy tissues before treatment with atorvastatin then in final surgical tissues specimens. Results: The median age of the patients was 49.5 ranging from 29 to 61 years. The vast majority of the patients had invasive duct carcinoma (IDC) and was positive for estrogen and progesterone receptors. The mean pretreatment Ki67 index was high in the majority of patients and was significantly associated with both tumor grade and estrogen receptor status (P = 0.001 and P= 0.003, respectively). The Ki67 index had decreased in the post-treatment samples after final surgery in 19 cases, increased in 8 cases and unchanged in 3 cases compared to the pre-treatment specimens. Tumor grade is a significant predictor of treatment response (p=0,05). Conclusion: Atorvastatin decreased tumor proliferation in breast cancer especially in high grade tumors and its role should be considered in the future studies.
Highlights
Statins, the cholesterol lowering drugs, appear to have pleiotropic effects independent of cholesterol level in both cardiovascular diseases and cancer for many decades [1]
Lipophilic statins interrupt the synthesis of mevalonate in the liver and in peripheral tissues, demonstrating cholesterol and pleiotropic effects but lipophobic statins mediate their effect in hepatocytes only, so, when studies examined the effect of lipophilic statins, they showed a protective role of lipophilic statins in prevention of breast cancer [5,6,7,8], other studies demonstrated in their animal models that lipophilic statins cause growth inhibition in breast cancer cell lines [9,10,11]
Data from phase II studies on statins implicated in the pre-operative setting showed reduced tumor cellular proliferation and increase in apoptosis in cases with high grade breast cancer, statins, anti-proliferative effects were confirmed in other studies, in which stain anti-proliferative effects were demonstrated in terms of changes of tumor levels of Ki67 index [12]
Summary
The cholesterol lowering drugs, appear to have pleiotropic effects independent of cholesterol level in both cardiovascular diseases and cancer for many decades [1]. Data from phase II studies on statins implicated in the pre-operative setting showed reduced tumor cellular proliferation and increase in apoptosis in cases with high grade breast cancer, statins, anti-proliferative effects were confirmed in other studies, in which stain anti-proliferative effects were demonstrated in terms of changes of tumor levels of Ki67 index [12]. The aim of this study was to assess the effect of pre-operative therapy with a statin (atorvastatin) on tumor proliferation in patients with newly diagnosed breast cancer. Immunohistochemical expression of Ki-67 staining of breast tumor cells was evaluated to assess tumor proliferation in biopsy tissues before treatment with atorvastatin in final surgical tissues specimens
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
