J Cancer 2017; 8(11):2026-2032. doi:10.7150/jca.18743

Research Paper

Impact of Statin Use on Outcomes in Triple Negative Breast Cancer

Simona F. Shaitelman1, Michael C. Stauder1, Pamela Allen1, Sangeetha Reddy2, Susan Lakoski3, Bradley Atkinson4, Jay Reddy1, Diana Amaya1, William Guerra1, Naoto Ueno2, Abigail Caudle4, Welela Tereffe1, Wendy A. Woodward1✉

1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
2. Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
3. Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, TX
4. Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX

Abstract

Purpose: We sought to investigate if the use of HMG Co-A reductase inhibitors (statins) has an impact on outcomes among patients with triple negative breast cancer (TNBC).

Methods: We reviewed the cases of women with invasive, non-metastatic TNBC, diagnosed 1997-2012. Clinical outcomes were compared based on statin use (defined as ever use during treatment vs. never use). We identified a subset of women for whom a 5-value lipid panel (5VLP) was available, including total cholesterol, low density lipoprotein, high density lipoprotein, very low density lipoprotein, and triglycerides. The Kaplan-Meier method was used to estimate median overall survival (OS), distant metastases-free survival (DMFS), and local-regional recurrence-free survival (LRRFS). A Cox proportional hazards regression model was used to test the statistical significance of prognostic factors.

Results: 869 women were identified who met inclusion criteria, with a median follow-up time of 75.1 months (range 2.4-228.9 months). 293 (33.7%) patients used statins and 368 (42.3%) had a 5VLP. OS, DMFS, and LRRFS were not significant based on statin use or type. Controlling for the 5VLP values, on multivariable analysis, statin use was significantly associated with OS (HR 0.10, 95% CI 0.01-0.76), but not with DMFS (HR 0.14, 95% CI 0.01-1.40) nor LRRFS (HR 0.10 95% CI 0.00-3.51).

Conclusions: Statin use among patients with TNBC is not associated with improved OS, although it may have a benefit for a subset of patients. Prospective assessment would be valuable to better assess the potential complex correlation between clinical outcome, lipid levels, and statin use.

Keywords: breast cancer, triple negative, statin, cholesterol

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How to cite this article:
Shaitelman SF, Stauder MC, Allen P, Reddy S, Lakoski S, Atkinson B, Reddy J, Amaya D, Guerra W, Ueno N, Caudle A, Tereffe W, Woodward WA. Impact of Statin Use on Outcomes in Triple Negative Breast Cancer. J Cancer 2017; 8(11):2026-2032. doi:10.7150/jca.18743. Available from http://www.jcancer.org/v08p2026.htm