Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Manchester University NHS Foundation Trust, Manchester, United Kingdom; NIHR/Wellcome Trust Clinical Research Facility, Manchester, United Kingdom.
Faculty of Medicine, University of Kurdistan, Erbil, Iraq.
Clin Ther. 2024 May;46(5):411-419. doi: 10.1016/j.clinthera.2024.03.004. Epub 2024 May 13.
There are inconsistent reports of an association between low cholesterol, use of lipid-lowering agents, and carcinogenesis. The purpose of this paper was to examine the relationship between cancer, lipids, statin use, and use of other lipid-lowering therapies.
This comprehensive literature review incorporated article searches in electronic databases (Embase, PubMed, OVID) and reference lists of relevant articles, with the authors' expertise in lipidology. This review considered seminal and novel research looking at the relationship between cholesterol, lipid-lowering therapies, and cancer.
Statin use has been reported to reduce the risk for incident cancer or progression of cancer; however, it is unknown whether this reduced risk of carcinogenesis is due to the pleotropic properties of statins or the effects of low cholesterol. The effect of ezetimibe on carcinogenesis has been regarded as neutral, despite earlier concerns of increased cancer risk with its use. Proprotein convertase subtilisin/kexin (PCSK)-9 monoclonal antibodies have been shown to have a neutral effect on carcinogenesis. Despite anti-cancer effects of fibrates in vitro, studies in humans have yielded inconsistent outcomes leaning toward protection against the development and progression of cancer.
Statins, fibrates, PCSK9 monoclonal antibodies, and ezetimibe have a neutral effect on cancer risk, and the first three may provide some protection. PSCK9 monoclonal antibodies have the potential to enhance the response to checkpoint inhibitor therapy for cancer. Further research is needed to determine which drugs can be issued in adjuvant therapy to improve outcomes in patients undergoing cancer treatment.
胆固醇水平低、使用降脂药物与癌症发生之间的关系存在不一致的报告。本文的目的是研究癌症、脂质、他汀类药物使用与其他降脂治疗方法之间的关系。
本综合文献复习纳入了电子数据库（Embase、PubMed、OVID）中的文章搜索以及相关文章的参考文献列表，作者在脂质学方面具有专业知识。本综述考虑了胆固醇、降脂治疗与癌症之间关系的开创性和新颖性研究。
他汀类药物的使用已被报道可降低癌症发病或癌症进展的风险；然而，尚不清楚这种降低致癌风险是由于他汀类药物的多效性特性还是由于胆固醇水平降低的影响。尽管之前曾担心其使用会增加癌症风险，但依折麦布对致癌作用的影响被认为是中性的。前蛋白转化酶枯草溶菌素 9（PCSK）-9 单克隆抗体已被证明对致癌作用无影响。尽管贝特类药物在体外具有抗癌作用，但人类研究的结果不一致，倾向于对癌症的发生和发展起到保护作用。
他汀类药物、贝特类药物、PCSK9 单克隆抗体和依折麦布对癌症风险的影响呈中性，前三种药物可能具有一定的保护作用。PCSK9 单克隆抗体有可能增强癌症患者对检查点抑制剂治疗的反应。需要进一步研究以确定哪些药物可用于辅助治疗，以改善接受癌症治疗的患者的治疗效果。
