Use of Lipophilic Statins is Associated with Lower Mortality from Ovarian Cancer

PHILADELPHIA – Lipophilic statins, a type of medication commonly prescribed to lower blood cholesterol, were associated with reduced mortality in patients with ovarian cancer, according to a study presented at the American Association for Cancer Research (AACR) Virtual Annual Meeting II, held online June 22-24.

Ovarian cancer is a rare cancer type, accounting for only about 1.2 percent of cancer cases diagnosed in the United States each year. It has a five-year survival rate of less than 50 percent, in part due to difficulty of diagnosis.

“There are no proven screening strategies, so the disease is typically diagnosed at an advanced stage, when surgery is often not an option,” said Kala Visvanathan, MD, MHS, professor of epidemiology and oncology at Johns Hopkins Bloomberg School of Public Health and Sidney Kimmel Comprehensive Cancer Center in Baltimore.

About 28 percent of U.S. adults over age 40 routinely take statins for cholesterol control. Visvanathan said they are widely used in other countries as well. The few smaller studies that have evaluated statins and mortality in ovarian cancer patients have shown mixed results. The large sample size of this study of more than 10,000 women with ovarian cancer allowed researchers to evaluate different statin types and their impact on different subtypes of ovarian cancer.

The researchers linked data from the Finnish national cancer registry to prescription claims on 10,062 women diagnosed with ovarian cancer between 1995 and 2015 to examine the association between pre- and post-diagnostic statin use and ovarian cancer mortality. Of the 10,062 patients, 2,621 used statins, and 80 percent of those used lipophilic statins. The median age at diagnosis was 62 overall, and 67 among statin users.

Statins are classified based on their solubility; lipophilic statins such as simvastatin and lovastatin dissolve in fats, while hydrophilic statins such as pravastatin and rosuvastatin dissolve in water. Use of any statins was associated with a 40 percent reduction in ovarian cancer mortality compared with patients who never used statins. Lipophilic statins specifically were associated with a 43 percent reduction in ovarian cancer mortality.

Women with all subtypes of ovarian cancer experienced a reduction in mortality, but the magnitude of reduction varied. The most significant reductions in mortality occurred in those with high-grade serous carcinoma (40 percent reduction in mortality) and endometrioid ovarian cancer (50 percent reduction in mortality). Visvanathan said the improved survival data across all ovarian cancer types were encouraging, but noted data for the rarer ovarian cancer subtypes were less robust. Some women initiated the use of lipophilic statins after receiving an ovarian cancer diagnosis, and they, too, experienced reduced mortality.

“Our results provide further evidence in support of the clinical evaluation of lipophilic statins as part of the treatment of ovarian cancer,” Visvanathan said. “These drugs are appealing as they are widely used, inexpensive, and well tolerated in most patients. The associated reduction in ovarian cancer mortality is promising.

Visvanathan noted that the results would need to be confirmed in randomized clinical trials and studied in other populations before becoming part of standard practice. She added that ovarian cancer is difficult to examine in long-term studies because of the low survival rate. This study benefited from high-quality data and the ability to evaluate data collected over many years.

This study was funded by the Department of Defense and the Breast Cancer Research Foundation. Coauthors were Shari Modur, PhD; Brenna Hogan, MPH; Betty May, MS; Miia Artama, PhD; and Teemu Murtola, MD, PhD. The researchers declare no conflicts of interest.