Department of Medicine, University of Vermont, Burlington, Vermont.
Department of Mathematics and Statistics, University of Vermont, Burlington, Vermont.
Cancer Prev Res (Phila). 2016 May;9(5):379-84. doi: 10.1158/1940-6207.CAPR-15-0300. Epub 2016 Feb 23.
Statins have the potential to reduce breast cancer incidence and recurrence as shown in both epidemiologic and laboratory studies. The purpose of this study was to evaluate the effect of a lipophilic statin, atorvastatin, on breast cancer biomarkers of risk [mammographic density (MD) and insulin growth factor 1 (IGF-1)] in high-risk premenopausal women.Premenopausal women at increased risk for breast cancer received either 40 mg of atorvastatin or placebo for 1 year. Biomarker assessment was performed prior to initiation and at completion of study medication. MD was determined using both Breast Imaging Reporting and Data System and the visual analogue scale. Serum IGF-1 was determined by ELISA assay at the end of the study.Sixty-three women were enrolled between December 2005 and May 2010. Sixteen (25%) women withdrew. The mean age of participants was 43 (range, 35-50), 100% were white, and the average body mass index (BMI) was 26.4. The statin group demonstrated a significant decrease in cholesterol and low-density lipoprotein (LDL), suggesting compliance with study medication. After accounting for BMI, there was no difference in change in MD between groups. There was a significant increase in serum IGF-1 in the statin group.In this multi-institutional randomized prospective clinical trial of premenopausal women at increased risk for breast cancer, we did not see an effect of atorvastatin on MD. Further investigation of statins may be warranted; however, design of prior trials and potential mechanism of action of the agent need to be considered in the design of future trials. Cancer Prev Res; 9(5); 379-84. ©2016 AACR.
他汀类药物具有降低乳腺癌发病率和复发率的潜力,这在流行病学和实验室研究中都得到了证实。本研究的目的是评估亲脂性他汀类药物阿托伐他汀对高危绝经前妇女乳腺癌风险生物标志物(乳腺密度[MD]和胰岛素生长因子 1[IGF-1])的影响。
患有乳腺癌风险增加的绝经前妇女接受 40 毫克阿托伐他汀或安慰剂治疗 1 年。在开始和完成研究药物治疗前进行生物标志物评估。MD 使用乳腺成像报告和数据系统以及视觉模拟量表进行确定。在研究结束时通过 ELISA 测定血清 IGF-1。
2005 年 12 月至 2010 年 5 月期间共招募了 63 名妇女。16 名(25%)妇女退出。参与者的平均年龄为 43 岁(范围 35-50 岁),100%为白人,平均体重指数(BMI)为 26.4。他汀类药物组的胆固醇和低密度脂蛋白(LDL)显著降低,提示研究药物的依从性。在考虑 BMI 后,两组之间 MD 的变化无差异。他汀类药物组血清 IGF-1 显著增加。
在这项针对患有乳腺癌风险增加的绝经前妇女的多机构随机前瞻性临床试验中,我们没有看到阿托伐他汀对 MD 的影响。可能需要进一步研究他汀类药物;然而,在设计未来试验时,需要考虑先前试验的设计和药物作用的潜在机制。癌症预防研究; 9(5); 379-84. ©2016 AACR。