Zie ook literatuurlijsten van niet-toxische middelen, voeding en weinig belastende behandelingen bij specifiek verschillende vormen van kanker en operaties, chemo en bestraling van arts-bioloog drs. Engelbert Valstar.

3 november 2020: Bron: British Journal of Clinical Pharmalogy october 2020.

Voor vrouwen met borstkanker, darmkanker of een melanoom heeft het nemen van zogeheten lipidenverlagende medicijnen (LLM) (statines bv) een positieve invloed op de mediane overall overleving. 

De afname in het risico op overlijden was meer uitgesproken voor vrouwen die meer lipofiele dan hydrofiele statines gebruikten bij alle drie de vormen van kanker. Bij borstkanker en darmkanker was het verschil statistisch significant, bij een melanoom net niet, maar wel een verschil in risico op overlijden.

Zie ook dit studieverslag uit 2016: Nieuwe lipidenverlagende middelen – een doorbraak in cholesterolbehandeling?

Uit het studierapport vertaald:

Wat is er al bekend over dit onderwerp:

  • Preklinisch bewijs ondersteunt lipidenverlagende medicijnen, voornamelijk statines hebben antikanker eigenschappen.
  • Niet overtuigende observationele bevindingen van dit medicijn over het overlevingsvoordeel van kanker vereisen meer bewijs voor het herbestemmen van dit medicijn als adjuvante kankertherapie.

Wat deze studie toevoegt:

  • Therapietrouw aan lipidenverlagende medicatie is omgekeerd evenredig met een afname van de kankerspecifieke sterfte bij borstkanker, darmkanker en melanoom.
  • Lipofiele statines laten een grotere afname van kankerspecifiek overlijden zien.
  • De associatie met langere overall overleving wordt niet veranderd door hormoontherapie bij borstkanker.

Het volledige studierapport is gratis in te zien, klik op de titel, met hier het abstract.

Does adherence to lipid‐lowering medications improve cancer survival? A nationwide study of breast and colorectal cancer, and melanoma

First published: 20 October 2020
 

Funding information: National Health and Medical Research Council of Australia, Grant/Award Number: (GNT 1073898)

Abstract

Aims

Inconclusive findings of lipid‐lowering medications (LLMs) on cancer survival benefit require more evidence. We tested the hypothesis that adherence to this drug is associated with reduced cancer‐specific mortality in a homogeneous population who had used this drug before cancer diagnosis.

Methods

The Australian Cancer Database was linked to the Pharmaceutical Benefits Scheme database, and to the National Death Index (up to 2015). Medication adherence was calculated by proportion of days covered. Cox regression models with time‐varying covariates were used to derive multivariable‐adjusted cause‐specific hazard ratio (HR) and 95% confidence interval (CI) for the associations between adherence to LLMs, statins, lipophilic, and hydrophilic statins and cancer‐specific mortality.

Results

From 2003 to 2013, 3 separate cohorts of 20 046, 11 719 and 6430 female patients with newly diagnosed breast, colorectal cancer, and melanoma respectively were identified. The 1‐year adherence was similar at 1‐year prediagnosis in the 3 cohorts, on average 82%. Each 10% increase in 1‐year adherence to LLMs was inversely associated with cancer‐specific mortality among women with breast cancer (fully adjusted HR = 0.92, 95% CI 0.91–0.93), colorectal cancer (fully adjusted HR = 0.92, 95% CI 0.91–0.93), or melanoma (fully adjusted HR = 0.97, 95% CI 0.94–1.00). The reductions in cancer‐specific mortality were more pronounced for women who adhered to lipophilic than hydrophilic statins in all 3 cancers albeit not statistically significant for melanoma.

Conclusion

Among LLM users, adherence to this drug is associated with a decrease in cancer‐specific mortality. If confirmed, LLMs could be considered as an adjuvant cancer therapy to improve prognosis in cancer survivors.

What is already known about this subject

  • Preclinical evidence supports lipid‐lowering medications primarily statins have anticancer properties.
  • Inconclusive observational findings of this drug on cancer survival benefit require more evidence for repurposing this drug as adjuvant cancer therapy.

What this study adds

  • Adherence to lipid‐lowering medication is inversely associated with decline in cancer‐specific mortality in breast and colorectal cancer, and melanoma.
  • Lipophilic statins show greater reductions in cancer‐specific mortality.
  • The inverse association is not altered by receiving endocrine therapy in breast cancer.
REFERENCES
  • 1Gauthaman K, Fong CY, Bongso A. Statins, stem cells, and cancer. J Cell Biochem. 2009; 106(6): 975‐ 983.
  • 2Ahern TP, Lash TL, Damkier P, Christiansen PM, Cronin‐Fenton DP. Statins and breast cancer prognosis: evidence and opportunities. Lancet Oncol. 2014; 15(10): e461‐ e468.
  • 3Iannelli F, Lombardi R, Milone MR, et al. Targeting mevalonate pathway in cancer treatment: repurposing of statins. Recent Pat Anticancer Drug Discov. 2018; 13(2): 184‐ 200.
  • 4Kwan ML, Habel LA, Flick ED, Quesenberry CP, Caan B. Post‐diagnosis statin use and breast cancer recurrence in a prospective cohort study of early stage breast cancer survivors. Breast Cancer Res Treat. 2008; 109(3): 573‐ 579.
  • 5Lakha F, Theodoratou E, Farrington SM, et al. Statin use and association with colorectal cancer survival and risk: case control study with prescription data linkage. BMC Cancer. 2012; 12: 487.
  • 6Ng K, Ogino S, Meyerhardt JA, et al. Relationship between statin use and colon cancer recurrence and survival: results from CALGB 89803. J Natl Cancer Inst. 2011; 103(20): 1540‐ 1551.
  • 7Murtola TJ, Visvanathan K, Artama M, Vainio H, Pukkala E. Statin use and breast cancer survival: a nationwide cohort study from Finland. Plos One. 2014; 9:e110231.
  • 8Chae YK, Valsecchi ME, Kim J, et al. Reduced risk of breast cancer recurrence in patients using ACE inhibitors, ARBs, and/or statins. Cancer Invest. 2011; 29(9): 585‐ 593.
  • 9Nickels S, Vrieling A, Seibold P, et al. Mortality and recurrence risk in relation to the use of lipid‐lowering drugs in a prospective breast cancer patient cohort. Plos One. 2013; 8:e75088.
  • 10 Australian Institute of Health and Welfare. Medicines for cardiovascular disease. Cat. no. CVD 80. Canberra: AIHW. 2017.
  • 11 Australian Institute of Health and Welfare. Cancer in Australia: In brief 2019. Cancer series no. 122. Cat no. CAN 126. Canberra: AIHW. 2019.
  • 12 Australian Institute of Health and Welfare. Comparing an SLK‐based and a name‐based data linkage strategy: an investigation into the PIAC linkage. Data linkage series no. 11. Cat. no. CSI 11. Canberra: AIHW. 2011.
  • 13Mellish L, Karanges EA, Litchfield MJ, et al. The Australian pharmaceutical benefits scheme data collection: a practical guide for researchers. BMC Res Notes. 2015; 8: 634.
  • 14Raebel MA, Schmittdiel J, Karter AJ, Konieczny JL, Steiner JF. Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases. Med Care. 2013; 51(8 Suppl 3): S11‐ S21.
  • 15Nau D. Proportion of Days Covered (PDC) as a Preferred Method of Measuring Medication Adherence. http://ep.yimg.com/ty/cdn/epill/pdcmpr.pdf Accessed February 3, 2020.
  • 16Martin BC, Wiley‐Exley EK, Richards S, Domino ME, Carey TS, Sleath BL. Contrasting measures of adherence with simple drug use, medication switching, and therapeutic duplication. Ann Pharmacother. 2009; 43(1): 36‐ 44.
  • 17Chubak J, Boudreau DM, Wirtz HS, McKnight B, Weiss NS. Threats to validity of nonrandomized studies of postdiagnosis exposures on cancer recurrence and survival. J Natl Cancer Inst. 2013; 105(19): 1456‐ 1462.
  • 18Noordzij M, Leffondre K, van Stralen KJ, Zoccali C, Dekker FW, Jager KJ. When do we need competing risks methods for survival analysis in nephrology? Nephrol Dial Transplant. 2013; 28: 2670‐ 2677.
  • 19 Australian Bureau of Statistics. Socio‐Economic Indexes for Areas. 2011. http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa Accessed February 3, 2020.
  • 20 The Department of Health. 2.3 Accessibility Remoteness Index of Australia (ARIA) Remoteness Area (RA). 2011. Available from: http://www.health.gov.au/internet/publications/publishing.nsf/Content/ARIA-Review-Report-2011~ARIA-Review-Report-2011-2~ARIA-Review-Report-2011-2-2-3
  • 21Freed‐Pastor WA, Mizuno H, Zhao X, et al. Mutant p53 disrupts mammary tissue architecture via the mevalonate pathway. Cell. 2012; 148(1‐2): 244‐ 258.
  • 22Kodach LL, Bleuming SA, Peppelenbosch MP, Hommes DW, van den Brink GR, Hardwick JC. The effect of statins in colorectal cancer is mediated through the bone morphogenetic protein pathway. Gastroenterology. 2007; 133(4): 1272‐ 1281.
  • 23Tilkin‐Mariame AF, Cormary C, Ferro N, et al. Geranylgeranyl transferase inhibition stimulates anti‐melanoma immune response through MHC class I and costimulatory molecule expression. FASEB J. 2005; 19(11): 1513‐ 1515.
  • 24McMenamin UC, Murray LJ, Hughes CM, Cardwell CR. Statin use and breast cancer survival: a nationwide cohort study in Scotland. BMC Cancer. 2016; 16: 600.
  • 25Cardwell CR, Hicks BM, Hughes C, Murray LJ. Statin use after colorectal cancer diagnosis and survival: a population‐based cohort study. J Clin Oncol. 2014; 32(28): 3177‐ 3183.
  • 26Cardwell CR, Hicks BM, Hughes C, Murray LJ. Statin use after diagnosis of breast cancer and survival: a population‐based cohort study. Epidemiology. 2015; 26(1): 68‐ 78.
  • 27Borgquist S, Broberg P, Tojjar J, Olsson H. Statin use and breast cancer survival ‐ a Swedish nationwide study. BMC Cancer. 2019; 19: 54.
  • 28Gray RT, Coleman HG, Hughes C, Murray LJ, Cardwell CR. Statin use and survival in colorectal cancer: results from a population‐based cohort study and an updated systematic review and meta‐analysis. Cancer Epidemiol. 2016; 45: 71‐ 81.
  • 29Nielsen SF, Nordestgaard BG, Bojesen SE. Statin use and reduced cancer‐related mortality. N Engl J Med. 2012; 367(19): 1792‐ 1802.
  • 30Livingstone E, Hollestein LM, van Herk‐Sukel MP, et al. Statin use and its effect on all‐cause mortality of melanoma patients: a population‐based Dutch cohort study. Cancer Med. 2014; 3(5): 1284‐ 1293.
  • 31Tamim H, Monfared AA, LeLorier J. Application of lag‐time into exposure definitions to control for protopathic bias. Pharmacoepidemiol Drug Saf. 2007; 16(3): 250‐ 258.
  • 32Brookhart MA, Patrick AR, Dormuth C, et al. Adherence to lipid‐lowering therapy and the use of preventive health services: an investigation of the healthy user effect. Am J Epidemiol. 2007; 166(3): 348‐ 354.
  • 33Snyder CF, Frick KD, Peairs KS, et al. Comparing care for breast cancer survivors to non‐cancer controls: a five‐year longitudinal study. J Gen Intern Med. 2009; 24(4): 469‐ 474.
  • 34Desai P, Lehman A, Chlebowski RT, et al. Statins and breast cancer stage and mortality in the Women's Health Initiative. Cancer Causes Control. 2015; 26(4): 529‐ 539.
  • 35Campbell MJ, Esserman LJ, Zhou Y, et al. Breast cancer growth prevention by statins. Cancer Res. 2006; 66(17): 8707‐ 8714.
  • 36Kumar AS, Benz CC, Shim V, Minami CA, Moore DH, Esserman LJ. Estrogen receptor‐negative breast cancer is less likely to arise among lipophilic statin users. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive. Oncology. 2008; 17: 1028‐ 1033.
  • 37Zanders MM, van Herk‐Sukel MP, Vissers PA, Herings RM, Haak HR, van de Poll‐Franse LV. Are metformin, statin and aspirin use still associated with overall mortality among colorectal cancer patients with diabetes if adjusted for one another? Br J Cancer. 2015; 113(3): 403‐ 410.
  • 38Brewer TM, Masuda H, Liu DD, et al. Statin use in primary inflammatory breast cancer: a cohort study. Br J Cancer. 2013; 109(2): 318‐ 324.
  • 39Siddiqui AA, Nazario H, Mahgoub A, Patel M, Cipher D, Spechler SJ. For patients with colorectal cancer, the long‐term use of statins is associated with better clinical outcomes. Dig Dis Sci. 2009; 54(6): 1307‐ 1311.

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