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The relationship between post-diagnostic statin usage and breast cancer prognosis varies by hormone receptor phenotype: a systemic review and meta-analysis

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

A Correspondence to this article was published on 25 October 2021

Abstract

Background

Preclinical studies and epidemiologic data had indicated statins had antineoplastic properties in breast cancer patients. Since breast cancer treatment is based on its phenotype, it is important to explore influence of post-diagnosis statin usage on breast cancer patients with different phenotypes.

Methods

We searched the related studies between inception and August, 2019 from MEDLINE and EMBASE. A total of 7 studies with 24,541 patients were identified. Stata/SE 15.0 and Review Manager 5.3 were used to analyze data. Inconsistency index was used to estimate heterogeneity. Begg’s and Egger’s regression test was used to examine publication bias.

Results

Overall post-diagnostic statin use was associated with improved recurrence free survival (recurrence free survival (RFS); hazard ratio (HR) 0.74; 95% confidential interval (95% CI) 0.57–0.98), overall survival (overall survival (OS); HR 0.53; 95% CI 0.31–0.91) and cancer-specific survival (cancer-specific survival (CSS); and HR 0.61; 95% CI 0.41–0.91). In hormone receptor positive patients, statin use was associated with improved CSS (HR 0.74, 95% CI 0.65–0.84). No protective effect was found in either OS or RFS. In hormone receptor negative patients, statin was associated with reduced OS (HR 2.19, 95% CI 1.34–3.59) and reduced RFS, but without statistical significance.

Conclusions

Post-diagnostic statin use was associated with improved RFS, OS and CSS in breast cancer patients. Subgroup analysis indicted that the benefits of statin usage varied from hormone receptor phenotype type. Prospective randomized trial with patients of different hormone receptor types might be needed to help identify which subtype of breast cancer patients would benefit from post-diagnostic statin usage.

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Funding

This work was supported by National Natural Science Foundation of China [81402487].

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Authors and Affiliations

  1. Department of Medical Oncology, The Affiliated Hospital of Jiangnan University, Wuxi, China

    Wen-Huan Xu

  2. Department of General Surgery, The Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical University, Wuxi, 214002, China

    Yun-Hai Zhou

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  1. Wen-Huan Xu
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Contributions

Wen-Huan Xu: data collection, data analysis, writing manuscript, and idea generation; Yun-Hai Zhou: data collection, data analysis, and idea generation.

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Correspondence to Yun-Hai Zhou.

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Xu, WH., Zhou, YH. The relationship between post-diagnostic statin usage and breast cancer prognosis varies by hormone receptor phenotype: a systemic review and meta-analysis. Arch Gynecol Obstet 304, 1315–1321 (2021). https://doi.org/10.1007/s00404-021-06065-z

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  • DOI: https://doi.org/10.1007/s00404-021-06065-z

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