BACKGROUND: Epidemiologic and biochemical evidence suggest a role of statins and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) as anti-neoplastic agents. This study was designed to evaluate the association between the use of these agents and the risk of breast cancer recurrence. METHODS: We reviewed the medical records of patients treated for stage II/III breast cancer between 1999 and 2005. Statin and ACE-inhibitors/ARB users were defined as patients who took these medications for at least 6 months in no evidence of disease (NED) stage after the initial diagnosis. The primary outcome was disease-free survival and the secondary was overall survival. The Kaplan-Meier and Cox proportional hazard models were used. RESULTS: A total of 703 patients were included. The median and maximal of follow up was 55 and 118 months, respectively. A total of 168 patients used ACE-inhibitors/ARBs, 156 patients used statins, and 81 used both. Univariate analysis showed significant reduction in breast cancer recurrence among patients who used ACE-inhibitors/ARBs (hazard ratio (HR) = 0.57; 95% CI: 0.37-0.89; p = .013) or statins (HR = 0.43; 95% CI: 0.26-0.70; p < .001). After adjusting for multiple variables, the use of ACE-inhibitors/ARBs (HR = 0.49; 95% CI: 0.31-0.76; p = .002) and statins (HR = 0.40; 95% CI: 0.24-0.67; p < .001) remained significant and an additive effect was found on those who used both drugs (HR = 0.30 95% CI: 0.15-0.61; p = .001). No association was found regarding overall survival. CONCLUSIONS: The use of ACE-inhibitors/ARBs, statins, and the combination of both were all associated with a reduced risk of breast cancer recurrence. This observation should prompt further exploration.
BACKGROUND: Epidemiologic and biochemical evidence suggest a role of statins and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) as anti-neoplastic agents. This study was designed to evaluate the association between the use of these agents and the risk of breast cancer recurrence. METHODS: We reviewed the medical records of patients treated for stage II/III breast cancer between 1999 and 2005. Statin and ACE-inhibitors/ARB users were defined as patients who took these medications for at least 6 months in no evidence of disease (NED) stage after the initial diagnosis. The primary outcome was disease-free survival and the secondary was overall survival. The Kaplan-Meier and Cox proportional hazard models were used. RESULTS: A total of 703 patients were included. The median and maximal of follow up was 55 and 118 months, respectively. A total of 168 patients used ACE-inhibitors/ARBs, 156 patients used statins, and 81 used both. Univariate analysis showed significant reduction in breast cancer recurrence among patients who used ACE-inhibitors/ARBs (hazard ratio (HR) = 0.57; 95% CI: 0.37-0.89; p = .013) or statins (HR = 0.43; 95% CI: 0.26-0.70; p < .001). After adjusting for multiple variables, the use of ACE-inhibitors/ARBs (HR = 0.49; 95% CI: 0.31-0.76; p = .002) and statins (HR = 0.40; 95% CI: 0.24-0.67; p < .001) remained significant and an additive effect was found on those who used both drugs (HR = 0.30 95% CI: 0.15-0.61; p = .001). No association was found regarding overall survival. CONCLUSIONS: The use of ACE-inhibitors/ARBs, statins, and the combination of both were all associated with a reduced risk of breast cancer recurrence. This observation should prompt further exploration.
Authors: Gitte Vrelits Sørensen; Patricia A Ganz; Steven W Cole; Lars A Pedersen; Henrik Toft Sørensen; Deirdre P Cronin-Fenton; Jens Peter Garne; Peer M Christiansen; Timothy L Lash; Thomas P Ahern Journal: J Clin Oncol Date: 2013-05-06 Impact factor: 44.544
Authors: Kristine Pelton; Christine M Coticchia; Adam S Curatolo; Carl P Schaffner; David Zurakowski; Keith R Solomon; Marsha A Moses Journal: Am J Pathol Date: 2014-07 Impact factor: 4.307
Authors: Daniel P Regan; Jonathan W Coy; Kirti Kandhwal Chahal; Lyndah Chow; Jade N Kurihara; Amanda M Guth; Irina Kufareva; Steven W Dow Journal: J Immunol Date: 2019-04-10 Impact factor: 5.422
Authors: Denise M Boudreau; Onchee Yu; Jessica Chubak; Heidi S Wirtz; Erin J Aiello Bowles; Monica Fujii; Diana S M Buist Journal: Breast Cancer Res Treat Date: 2014-02-21 Impact factor: 4.872