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Scholarly Works (2 results)

  • Article
Public Health Sciences (2020)

• Due to advances in treatment and early detection, nearly 90% of women with breast cancer are living at least 5 years following their diagnosis

     o Living longer, there is increased risk for the development of longterm, late effects of cancer treatment

     o Cardiotoxicity may arise either during or after breast cancer treatments such as anthracyclines and/or trastuzumab

• Recent evidence has suggested the potential for statin use, a lipidlowering drug, during treatment to mitigate the risk of cardiotoxicity in patients receiving cardiotoxic chemotherapy

• Research Question: Does statin use lower the risk of cardiotoxicity among breast cancer patients who receive treatment with anthracyclines and/or trastuzumab?

    Cover page: Statins to mitigate cardiotoxicity in breast cancer patients treated with anthracyclines and/or trastuzumab: A systematic review and meta-analysis
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2021)

    Purpose

    Cardiotoxicity affects 5-16% of cancer patients who receive anthracyclines and/or trastuzumab. Limited research has examined interventions to mitigate cardiotoxicity. We examined the role of statins in mitigating cardiotoxicity by performing a systematic review and meta-analysis of published studies.

    Methods

    A literature search was conducted using PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Central. A random-effect model was used to assess summary relative risks (RR), weighted mean differences (WMD), and corresponding 95% confidence intervals. Testing for heterogeneity between the studies was performed using Cochran's Q test and the I2 test.

    Results

    Two randomized controlled trials (RCTs) with a total of 117 patients and four observational cohort studies with a total of 813 patients contributed to the analysis. Pooled results indicate significant mitigation of cardiotoxicity after anthracycline and/or trastuzumab exposure among statin users in cohort studies [RR = 0.46, 95% CI (0.27-0.78), p = 0.004, [Formula: see text] = 0.0%] and a non-significant decrease in cardiotoxicity risk among statin users in RCTs [RR = 0.49, 95% CI (0.17-1.45), p = 0.20, [Formula: see text] = 5.6%]. Those who used statins were also significantly more likely to maintain left ventricular ejection fraction compared to baseline after anthracycline and/or trastuzumab therapy in both cohort studies [weighted mean difference (WMD) = 6.14%, 95% CI (2.75-9.52), p < 0.001, [Formula: see text] = 74.7%] and RCTs [WMD = 6.25%, 95% CI (0.82-11.68, p = 0.024, [Formula: see text] = 80.9%]. We were unable to explore publication bias due to the small number of studies.

    Conclusion

    This meta-analysis suggests that there is an association between statin use and decreased risk of cardiotoxicity after anthracycline and/or trastuzumab exposure. Larger well-conducted RCTs are needed to determine whether statins decrease risk of cardiotoxicity from anthracyclines and/or trastuzumab.

    Trial registration number and date of registration

    PROSPERO: CRD42020140352 on 7/6/2020.
      Cover page: Statins to mitigate cardiotoxicity in cancer patients treated with anthracyclines and/or trastuzumab: a systematic review and meta-analysis
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