medwireNews: Statin use in the 12 months after diagnosis of early-stage triple-negative breast cancer (TNBC) is associated with improved survival in older women, findings indicate.
“Our results extend previous work supporting the association between statin therapy and improved outcomes in patients with breast cancer and specifically add weight to the strong preclinical evidence for a benefit of statin therapy in patients with aggressive breast cancer subtypes,” say the researchers.
“Statins are a safe, affordable, and low-risk intervention,” and therefore these findings “could have important public health implications,” they add.
The team collated data on 23,192 patients aged at least 66 years with stage I–III breast cancer who were included in the US SEER–Medicare and Texas Cancer Registry–Medicare databases between 2008 and 2015. Participants could not have used statins in the year prior to diagnosis and had to be alive for at least 12 months postdiagnosis.
As reported in Cancer, there was no significant difference in breast cancer-specific survival (BCSS) or overall survival (OS) between the 9.8% of women who initiated statins in the 12 months after diagnosis and the 90.2% who did not.
But in the subgroup of patients with TNBC (n=1534), multivariable analysis adjusting for a raft of confounders showed a significant association between statin use and improved BCSS and OS, with standardized hazard ratios of 0.42 and 0.70, respectively.
There were no such significant associations in the non-TNBC subgroup, and the findings “were consistent in fully adjusted models, when using propensity score matching, and when implementing conservative methods to account for selection bias and immortal time bias,” say Kevin Nead (The University of Texas MD Anderson Cancer Center, Houston, USA) and co-authors.
They also evaluated the associations by statin type, finding that the use of lipophilic, but not hydrophilic, statins correlated significantly with improved OS in patients with TNBC. The association with BCSS was “directionally consistent” albeit without reaching statistical significance, report the investigators.
And analysis by statin intensity revealed that high-intensity use as defined by the American College of Cardiology/American Heart Association guidelines “had the strongest effect on OS” in the TNBC group, with not enough events to assess BCSS, they continue.
Nead and colleagues therefore conclude that “[s]tatins may have a role in select patients with breast cancer, and further investigation is warranted.”
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