The effect of atorvastatin on breast cancer biomarkers in high-risk women
Mené sur 47 patientes présentant un risque élevé de cancer du sein (âge : 35 à 55 ans), cet essai multicentrique évalue l'effet d'une statine lipophile, l'atovarstatine, sur la densité mammaire et le niveau sérique du facteur de croissance IGF-1, deux biomarqueurs associés au risque de cancer du sein
Purpose : Statins have the potential to reduce breast cancer incidence and recurrence as shown in both epidemiological 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. Methods : 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 (BIRADs) and the Visual Analogue Scale (VAS). Serum IGF-1 was determined by ELISA assay at the end of the study. Results : Sixty-three women were enrolled between 12/05-5/10. Sixteen (25%) women withdrew. The mean age of participants was 43 (range 35-50), 100% were white, and the average BMI was 26.4. The statin group demonstrated a significant decrease in cholesterol and 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. Conclusions : 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.