Ahern, T. P.3; Lash, T. L.3; Damkier, P.4; Christiansen, P. M.3; Cronin-Fenton, D. P.3
1 Dept. Clinical Biochemistry and Pharmacology, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU2 Clinical Biochemistry, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU3 unknown4 Dept. Clinical Biochemistry and Pharmacology, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU
evidence and opportunities
Much preclinical and epidemiological evidence supports the anticancer effects of statins. Epidemiological evidence does not suggest an association between statin use and reduced incidence of breast cancer, but does support a protective effect of statins-especially simvastatin-on breast cancer recurrence. Here, we argue that the existing evidence base is sufficient to justify a clinical trial of breast cancer adjuvant therapy with statins and we advocate for such a trial to be initiated without delay. If a protective effect of statins on breast cancer recurrence is supported by trial evidence, then the indications for a safe, well tolerated, and inexpensive treatment can be expanded to improve outcomes for breast cancer survivors. We discuss several trial design opportunities-including candidate predictive biomarkers of statin safety and efficacy-and off er solutions to the key challenges involved in the enrolment, follow-up, and analysis of such a trial.