Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Aug 24, 2020; 11(8): 573-588
Published online Aug 24, 2020. doi: 10.5306/wjco.v11.i8.573
Statins in risk-reduction and treatment of cancer
Cristina I Barbalata, Lucia R Tefas, Marcela Achim, Ioan Tomuta, Alina S Porfire
Cristina I Barbalata, Lucia R Tefas, Marcela Achim, Ioan Tomuta, Alina S Porfire, Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, “Iuliu-Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400012, Romania
Author contributions: Barbalata CI wrote the manuscript with support from Tefas LR, Achim M and Porfire AS; Porfire AS and Barbalata CI conceived the idea and organized the manuscript; Porfire AS and Tomuta I supervised the project and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Alina S Porfire, PhD, Associate Professor, Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, “Iuliu- Hatieganu” University of Medicine and Pharmacy, 41 Victor Babes, Cluj-Napoca 400012, Romania.
Received: February 28, 2020
Peer-review started: February 28, 2020
First decision: April 29, 2020
Revised: May 18, 2020
Accepted: June 10, 2020
Article in press: June 10, 2020
Published online: August 24, 2020

Statins, which are competitive inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, reduce cholesterol blood levels and the risk of developing cardiovascular diseases and their related complications. In addition to this main activity, statins show pleiotropic effects such as antioxidant, anti-inflammatory and antiproliferative properties, with applications in many pathologies. Based on their antiproliferative properties, in vitro and in vivo studies have investigated their effects on various types of cancer (i.e., breast cancer, prostate cancer, colorectal cancer, ovarian cancer, lung cancer) with different genetic and molecular characteristics. Many positive results were obtained, but they were highly dependent on the physiochemical properties of the statins, their dose and treatment period. Combined therapies of statins and cytotoxic drugs have also been tested, and synergistic or additive effects were observed. Moreover, observational studies performed on patients who used statins for different pathologies, revealed that statins reduced the risk of developing various cancers, and improved the outcomes for cancer patients. Currently, there are many ongoing clinical trials aimed at exploring the potential of statins to lower the mortality and the disease-recurrence risk. All these results are the foundation of new treatment directions in cancer therapy.

Keywords: Statins, Cancer, Pleiotropic effects, Risk reduction, Clinical trials, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, Mevalonate pathway

Core tip: In the last few years, statins have been increasingly studied for their anticancer properties. This review presents the application of statins in cancer management by outlining the latest in vitro and in vivo studies. The results represent the foundation of the latest clinical trials in order to search for new treatment directions in cancer therapy.