Blood cancer patients could face better survival rates if they take common cholesterol-reducing drugs alongside other treatments, new UAE research has found.
A study by the University of Sharjah found a 61 per cent lower risk of death within five years in 1,467 leukaemia patients who took statins during their cancer treatment.
In four separate clinical trials between 2012 and 2019, around one third of participants diagnosed with chronic lymphocytic leukaemia (CLL) were also taking statins to treat other health conditions such as cardiovascular disease and hypertension.
As well as significantly reduced mortality, researchers also found the risk of their disease progressing among patients on statins was reduced by 26 per cent.
Doctors called for more research to further investigate the effects of statins on cancer, and said the findings could open the door to more affordable and accessible treatments to complement medical efforts to treat leukaemia, and other cancers.
“Beyond their effect on lowering cholesterol, statins have been known to have anti-inflammatory and anti-angiogenic effects,” said Dr Ahmad Abuhelwa, an assistant professor of pharmacy practice and pharmacotherapeutics at the University of Sharjah who led the study.
“They've also been shown in lab studies to disrupt cancer cell survival pathways and induce cancer cell death. The significance of this is that because statins are widely available, affordable and well-tolerated medications. We're hoping this will open the door for future research into drug repurposing as a cost-effective strategy to improve cancer outcomes.
“If future prospective clinical trials confirm their benefits, then statins could become an easy and cost-effective way to improve survival in patients with CLL. We're hoping this will spark future research looking at how statins affect other types of cancers, like breast, colon or lung cancer.”
The clinical trials assessed were not specifically searching for the effects of statins. But as many of the cancer patients surveyed were over 60 and had been prescribed the drug to treat existing co-morbidities, scientists could also evaluate the impact of statins on their survival.
There are four main types of leukaemia: acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML). They account for around 3 per cent of cancer deaths worldwide.
A Global Burden of Disease study carried across three decades showed an increased incidence of CLL, with 100,000 new cases and 40,000 related deaths in 2019. Survival rates vary, with around 67 per cent of people diagnosed with leukaemia living beyond five years in the US, while that number rises to 88 per cent in cases of CLL.
“On average, patients with cancer take seven medications to treat comorbidities or side effects,” said Dr Abuhelwa. “Patients are often worried whether medications like statins could negatively impact their treatment.
“What we're seeing here is statins being a positive prognostic factor, so it's actually on the good side, not bad. It's important to reassure patients that such concurrent medications are not harmful and can actually provide a dual benefit.”
One study analysing patients listed at the Sheikh Shakhbout Medical City (SSMC) leukaemia registry reported CLL accounted for only about 3 per cent of leukaemia cases treated there. In contrast, CLL is the most common leukaemia in adults living in Western populations, often accounting for 25-35 per cent of all leukaemias.
Dr Humaid Al Shamsi, head of Emirates Oncology Society and chief executive of Burjeel Cancer Institute, said the research was significant and could pave the way for further developments in the use of statins. “The key finding is that patients with CLL or SLL who were taking statins when starting treatments like ibrutinib had significantly better outcomes,” he said.
“The study identified statin use as an independent positive prognostic factor, meaning this benefit was observed even after accounting for other factors like age, disease characteristics and other medications.
"Importantly, this survival benefit was seen regardless of whether the patient was receiving ibrutinib or other comparison treatments used in the trials, and no significant increase in severe side effects.”
The study found the anti-inflammatory effects of statins could influence the micro-environment of a cancerous tumour, while enhancing the impact of certain drugs used to treat CLL, such as venetoclax.
A pooled analysis of the research was peer reviewed and published on April 23, following a long period of data acquisition and statistical analysis. Despite the positive signs, Dr Al Shamsi said further research was required before the findings would directly change clinical practice for treating leukaemia.
“While the results are promising and suggest statins might be beneficial, this study was retrospective, as it looked back at patients who happened to be taking statins for other reasons, like high cholesterol,” he said.
“It shows an association, but doesn't definitively prove causation. To confirm these findings and understand if actively prescribing statins improves outcomes, prospective randomised controlled trials (RCTs) would be needed.
“In such trials, patients would be randomly assigned to receive a statin or a placebo alongside their cancer treatment, allowing for a more direct assessment of the statin's effect.”
