What are Statins?
- Statins are a type of drug that blocks the enzyme HMG-CoA reductase, which the body needs to make cholesterol
- Statins help to treat and prevent heart disease by lowering blood cholesterol
- Research suggests that statins may lower the risk of certain cancers such as colorectal and skin cancers. This is because statins work against cellular functions that may help control tumor initiation, tumor growth, and metastasis
- Two cardiovascular clinical trials have demonstrated a significant reduction in skin cancer among patients taking lipid-lowering drug
According the National Cancer Institute..
Animal research and ongoing observation of people who take statins suggest that these drugs may lower the risk of certain cancers, including colorectal and skin cancers. Statins' known benefits in preventing cardiovascular disease, along with years of strong evidence that these agents are relatively safe, have led researchers to explore whether statins have the potential to prevent cancer. People should not take statins for cancer prevention outside of a clinical trial.
Specifically, statins reduce (or block) the activity of the enzyme HMG-CoA reductase and thereby reduce the levels of mevalonate and its associated products. The mevalonate pathway plays a role in cell membrane integrity, cell signaling, protein synthesis, and cell cycle progression, all of which are potential areas of intervention to arrest the cancer process.
Potential Side Effects
Although generally well-tolerated, statins have been associated with muscle pain (myopathy) and liver toxicity (hepatotoxicity). People who take statins should be monitored by their health care providers for these reasons.
NCI's Cancer Prevention Clinical Trials Consortia initiated a trial for people at increased risk for colorectal cancer who also have been found to have aberrant crypt foci (ACF), in 2005. ACF are clusters of abnormal cells in the lining of the colon and rectum that have been associated with the development of colorectal tumors. Using existing technology, ACF represent the earliest stage of detectable risk for colorectal cancer.
Patients diagnosed with stage I or II colon cancer are eligible for this trial after they have undergone surgical treatment (resection) to remove their primary tumor. Patients may also have received post-surgical (adjuvant) therapy. Study participants will be stratified (categorized) according to whether or not they have a family history of colorectal cancer, whether they regularly take aspirin and at what dose (none, 81 mg, or 325 mg), and whether they received prior adjuvant therapy. They will then be randomly assigned to take either rosuvastatin (Crestor) or a placebo pill daily for 5 years.
Participants will have physical exams every 6 months during the 5-year study period and will undergo complete colonoscopies within 180 days before randomization, and at 1, 3, and 5 years afterward. Doctors will follow the participants for the development of adenomatous polyps, the incidence of metachronous colorectal cancers, and the recurrence of their primary colon cancer.
“We’re also very interested in aspirin because we know that it has some benefit in preventing colorectal polyps and cancer. So, this study is designed to accept people who currently take aspirin as long as they agree to continue their aspirin over the course of the study,” added Dr. Bruce Boman (Protocol Chair), National Surgical Adjuvant Breast and Bowel Project.
Like statins, aspirin is widely used to protect the heart. The long-term use of aspirin has been shown to provide protection against the development of colorectal polyps and cancer. Since statins and aspirin are often used together, researchers are interested in exploring their ability, when combined, to prevent colorectal polyps and cancer. A recent case-control study examined the effects of a daily statin and low-dose aspirin, individually and together, on the development of colorectal tumors. The researchers found that using both drugs together reduced colorectal cancer risk more than the use of either drug alone. Consequently, one of the secondary endpoints in the NSABP-P-5 trial is to see if the combination of rosuvastatin and aspirin has either additive or synergistic effects.
For More Information
Call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). The toll-free call is confidential.