Holmes Michelle D, Chen Wendy Y
Breast Cancer Res. 2012 Dec 10;14(6):216. doi: 10.1186/bcr3336.
Many medications have been developed for one purpose but then are found to have other clinical activities. There is tremendous interest in whether non-cancer medications may potentially have effects on breast cancer survival. In this review article, we have presented and evaluated the evidence for several commonly used over-the-counter and prescription medications - including aspirin (and other non-steroidal anti-inflammatory drugs), beta-blockers, angiotensin-converting enzyme inhibitors, statins, digoxin, and metformin - that have been evaluated among breast cancer survivors in prospective studies. Substantial scientific evidence supports the hypothesis that some of these common and relatively safe drugs may reduce breast cancer mortality among those with the disease by an amount that rivals the mortality reduction gained by currently used therapies. In particular, the evidence is strongest for aspirin (approximately 50% reduction), statins (approximately 25% reduction), and metformin (approximately 50% reduction). As these drugs are generic and inexpensive, there is little incentive for the pharmaceutical industry to fund the randomized trials that would show their effectiveness definitively. We advocate that confirmation of these findings in randomized trials be considered a high research priority, as the potential impact on human lives saved could be immense.
许多药物最初是为某一目的而研发的，但后来发现它们还有其他临床作用。非癌症药物是否可能对乳腺癌患者的生存产生影响，这引发了人们极大的兴趣。在这篇综述文章中，我们展示并评估了几种常用非处方药和处方药的相关证据，这些药物包括阿司匹林（及其他非甾体抗炎药）、β受体阻滞剂、血管紧张素转换酶抑制剂、他汀类药物、地高辛和二甲双胍，它们已在前瞻性研究中对乳腺癌幸存者进行了评估。大量科学证据支持这样一种假说，即这些常见且相对安全的药物中的一些，可能会使患乳腺癌者的死亡率降低，降低幅度可与目前使用的疗法相媲美。特别是，阿司匹林（降低约50%）、他汀类药物（降低约25%）和二甲双胍（降低约50%）的证据最为确凿。由于这些药物是通用的且价格低廉，制药行业几乎没有动力资助能明确显示其有效性的随机试验。我们主张，在随机试验中证实这些发现应被视为一项高度优先的研究事项，因为这对挽救人类生命可能产生的影响是巨大的。
