Wang Ange, Wakelee Heather A, Aragaki Aaron K, Tang Jean Y, Kurian Allison W, Manson JoAnn E, Stefanick Marcia L
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Curr Atheroscler Rep. 2016 Dec;18(12):72. doi: 10.1007/s11883-016-0625-y.
PURPOSE OF REVIEW: Statins are one of the most widely prescribed drug classes in the USA. This review aims to summarize recent research on the relationship between statin use and cancer outcomes, in the context of clinical guidelines for statin use in patients with cancer or who are at high risk for cancer. RECENT FINDINGS: A growing body of research has investigated the relationship between statins and cancer with mixed results. Cancer incidence has been more extensively studied than cancer survival, though results are inconsistent as some large meta-analyses have not found an association, while other studies have reported improved cancer outcomes with the use of statins. Additionally, two large studies reported increased all-cancer survival with statin use. Studies on specific cancer types in relation to cancer use have also been mixed, though the most promising results appear to be found in gastrointestinal cancers. Few studies have reported an increased risk of cancer incidence or decreased survival with statin use, though this type of association has been more commonly reported for cutaneous cancers. The overall literature on statins in relation to cancer incidence and survival is mixed, and additional research is warranted before any changes in clinical guidelines can be recommended. Future research areas include randomized controlled trials, studies on specific cancer types in relation to statin use, studies on populations without clinical indication for statins, elucidation of underlying biological mechanisms, and investigation of different statin types. However, studies seem to suggest that statins may be protective and are not likely to be harmful in the setting of cancer, suggesting that cancer patients who already take statins should not have this medication discontinued.
综述目的:他汀类药物是美国处方量最大的药物类别之一。本综述旨在总结近期关于他汀类药物使用与癌症结局之间关系的研究,同时结合癌症患者或癌症高危患者使用他汀类药物的临床指南进行探讨。 最新发现:越来越多的研究对他汀类药物与癌症之间的关系进行了调查,但结果不一。与癌症生存率相比,癌症发病率的研究更为广泛,不过结果并不一致,一些大型荟萃分析未发现两者存在关联,而其他研究则报告使用他汀类药物可改善癌症结局。此外,两项大型研究报告称使用他汀类药物可提高全癌生存率。关于特定癌症类型与他汀类药物使用关系的研究结果也各不相同,不过最有前景的结果似乎出现在胃肠道癌症中。很少有研究报告使用他汀类药物会增加癌症发病率或降低生存率,不过这种关联在皮肤癌中更为常见。关于他汀类药物与癌症发病率和生存率关系的总体文献结果不一,在建议对临床指南进行任何更改之前,还需要进行更多研究。未来的研究领域包括随机对照试验、关于特定癌症类型与他汀类药物使用关系的研究、对无他汀类药物临床适应证人群的研究、对潜在生物学机制的阐明以及对不同类型他汀类药物的研究。然而,研究似乎表明他汀类药物可能具有保护作用,在癌症背景下不太可能有害,这表明已经在服用他汀类药物的癌症患者不应停用该药物。
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