In a large observational study of women with epithelial ovarian cancer, use of a cholesterol-lowering statin was associated with a significant reduction in ovarian-cancer-specific mortality and the benefit was greatest in those taking a lipophilic statin. "Statins inhibit the first enzyme in the mevalonate pathway. Products of the pathway have been implicated in tumorigenesis, including tumor growth, proliferation, and angiogenesis. Lipophilic statins also demonstrate prominent immunologic effects and can impact immunosurveillance," said lead researcher Dr. Kala Visvanathan at a press briefing held during the American Association for Cancer Research (AACR) second virtual annual meeting. The few small studies that have evaluated statins and mortality in ovarian-cancer patients have shown mixed results, said Dr. Visvanathan, with Johns Hopkins Bloomberg School of Public Health and Sidney Kimmel Comprehensive Cancer Center in Baltimore, Maryland. To investigate further, the researchers linked data from the Finnish national cancer registry to prescription claims for women diagnosed with ovarian cancer between 1995 and 2015. Of the more than 10,000 women included in the analysis, 2,621 used statins for a median of 7.5 years. During median follow-up of four years, use of any statin - lipophilic (such as simvastatin or lovastatin) or hydrophilic (such as pravastatin or rosuvastatin) - was associated with a 40% reduction (range 34% to 46%) in ovarian-cancer mortality compared with never use. Lipophilic statins specifically were associated with a 43% reduction (95% confidence interval, 24% to 57%) in ovarian-cancer mortality (range, 24% to 57%) and there was a trend toward greater reduction in mortality with increasing dose (P trend = 0.06). Lipophilic-statin use was associated with a reduction in ovarian-cancer death among all tumor subtypes, but the magnitude of reduction varied. The most significant reductions in mortality occurred in those with endometrioid ovarian cancer and high-grade serous carcinoma (50% and 40% reduction in mortality, respectively). In her presentation, Dr. Visvanathan noted that the five-year survival rate for ovarian cancer in the U.S. and other developed countries "remains less than 15%. There are no proven screening strategies, and there's an urgent need to find cheaper effective treatment alternatives." "Our results support further clinical evaluation of lipophilic statins in women with epithelial ovarian cancer in a randomized controlled trial in conjunction with existing therapies. Our results also reinforce the value of examining existing therapies that are well tolerated and inexpensive to reduce global cancer burden," Dr. Visvanathan concluded. Briefing co-moderator Dr. Antoni Ribas of the University of California, Los Angeles, said the observation of reduced ovarian-cancer-specific mortality with statin therapy is "provocative and needs to be validated with a prospective randomized trial and the data provides a justification for starting such a study." The study had no commercial funding and the authors have disclosed no relevant conflicts of interest. —Megan Brooks Source
