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March 19, 2020
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Statins may reduce HF hospitalization after chemotherapy for breast cancer

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Among women undergoing chemotherapy for early-stage breast cancer, statin exposure reduced risk for hospitalization due to HF by up to 66%, according to a retrospective population-based cohort study presented at the American College of Cardiology Scientific Session.

“Anthracyclines and trastuzumab are two commonly used drugs in breast cancer treatment that can cause cardiac damage,” David Bobrowski, third-year medical student at the University of Toronto, said during a consumer web briefing. “Despite these cardiac risks, the effectiveness of these medications, anthracyclines and trastuzumab, for breast cancer treatment means we cannot forgo their use, which necessitates that we protect the heart.”

Women with early-stage breast cancer who received statin therapy while undergoing chemotherapy with anthracyclines experienced a 58% risk reduction for HF hospitalization (HR = 0.42; 95% CI, 0.22-0.82) compared with women administered anthracyclines who did not receive statin therapy.

In addition, patients who received statins combined with trastuzumab (Herceptin, Genentech) for chemotherapy experienced a 66% risk reduction for HF hospitalization (HR = 0.34; 95% CI, 0.14-0.82) compared with women administered trastuzumab who did not take statins.

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Statin exposure reduced risk for hospitalization due to HF by up to 66% in women who underwent chemotherapy for early-stage breast cancer

“To date, there has been limited evidence supporting the safety and effectiveness of large-scale use of cardioprotective medications for patients with early-stage breast cancer,” Bobrowski said in a press release. “Angiotensin antagonists and beta-blockers have only shown modest cardioprotective effects in clinical trials, and these medicines are sometimes poorly tolerated in this population given their side effects of fatigue and dizziness, which many patients already have from their cancer therapies or the cancer itself.”

For this analysis, researchers matched women with early-stage breast cancer undergoing chemotherapy combined with statin therapy to women who were not receiving statin therapy, resulting in 723 pairs of women treated with anthracycline (mean age, 69 years) and 399 pairs of women treated with trastuzumab (mean age, 71 years).

“Statin exposure is associated with a lower risk of heart failure requiring hospital-based care after anthracyclines and trastuzumab-based chemotherapy in early-stage breast cancer,” Bobrowski said during the presentation. “These findings provide support for prospective clinical trial to determine if pretreatment with statins is actually an effective intervention to prevent cardiac toxicity secondary to anthracyclines and trastuzumab.” – by Scott Buzby

Reference:

Bobrowski D, et al. Abstract 1157-079. Presented at: American College of Cardiology Scientific Session; March 28-30, 2020 (virtual meeting).

Disclosure: Bobrowski reports no relevant financial disclosures.