Statins and breast cancer prognosis: evidence and opportunities.
Statins and breast cancer prognosis: evidence and opportunities.
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DOI：
10.1016/s1470-2045(14)70119-6
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发表时间：
2014-09
期刊：
影响因子：
--
通讯作者：
Cronin-Fenton DP
中科院分区：
文献类型：
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作者：
Ahern TP;Lash TL;Damkier P;Christiansen PM;Cronin-Fenton DP
许多临床前和流行病学证据支持HMG-CoA还原酶抑制剂（他汀类药物）的抗癌作用。流行病学证据并不支持他汀类药物的使用与乳腺癌发病率降低之间的关联，但确实支持他汀类药物（尤其是辛伐他汀）对乳腺癌预后的保护作用。我们认为，目前的证据基础足以证明乳腺癌辅助治疗与他汀类药物的临床试验。我们主张毫不拖延地开始这样的审判。如果他汀类药物对乳腺癌复发的保护作用得到试验证据的支持，那么可以扩大安全，耐受性良好和昂贵治疗的适应症，以改善乳腺癌幸存者的结局。我们讨论了几个设计机会，包括他汀类药物的安全性和有效性的候选预测生物标志物，并提供解决方案，以招募，随访和分析这样一个试验的关键挑战。
Much preclinical and epidemiologic evidence supports anticancer effects of HMG-CoA reductase inhibitors (statins). Epidemiologic evidence does not support an association between statin use and reduced breast cancer incidence, but does support a protective effect of statins—particularly simvastatin—on breast cancer prognosis. We argue that the current evidence base is sufficient to justify a clinical trial of breast cancer adjuvant therapy with statins. We advocate for such a trial to be initiated without delay. If a protective effect of statins on breast cancer recurrence is supported by trial evidence, then the indications for a safe, well-tolerated, and in expensive treatment can be expanded to improve outcomes for breast cancer survivors. We discuss several design opportunities—including candidate predictive biomarkers of statin safety and efficacy—and offer solutions to key challenges to enrolment, follow-up, and analysis of such a trial.