Repurposing Statin Drugs to Decrease Toxicity and Improve Survival Outcomes in Head and Neck Cancer

Abstract

Objective The rising incidence of head and neck squamous cell carcinoma (HNSCC) calls for the assessment and improvement of currently available therapies that may enhance the therapeutic ratio in these patients. Statin drugs are one of the most widely used drug classes in the world for their lipid-lowering properties. As such, statins have been widely studied and found to possess pleiotropic effects that may make them effective in cancer treatment and toxicity mitigation. The aim of this review is to examine the potential use of statin drugs as adjunctive therapy in patients with HNSCC. Data Sources PubMed. Review Methods Any preclinical or clinical articles pertaining to the effects of statin drugs on treatment-related toxicity or survival outcomes in patients with head and neck cancer were included in this narrative review. Conclusions Emerging data suggest that statins may improve survival and reduce toxicities associated with chemotherapy and radiotherapy in patients with head and neck cancer, by mechanisms that are poorly understood at present. Implications for Practice Given their affordability and safety, statins deserve further study as a tool to improve oncologic outcomes and enhance survivorship in patients with HNSCC.

Statins in Cancer Prevention and Therapy

“…Added to radiation, systemic therapy improves local control and overall survival; however, many patients experience severe adverse events during treatment and debilitating long-term toxicities, raising interest in de-escalation, particularly for HPV + disease [118]. Statins may offer the opportunity to reduce the intensity of treatment and/or eliminate the need for radiation or chemotherapy, given their potential to improve the benefits and reduce toxicity [119]. Indeed, several retrospective studies have reported that incidental statin use is associated with improved outcomes in HNSCC [120][121][122].…”

The roles of ATP‐binding cassette transporter A1 and its substrate cholesterol in head and neck cancers

“…Many patients with HNCs are at risk of developing a cerebrovascular incident (stroke) and transient ischemic attack due to radiation. At 20 years after ending radiation therapy, the rate of stroke has been notified to be higher as 24%, compared with only 5% in the overall population (Bourguillon et al, 2021). There has been convincing proof that statins can help prevent vascular damage stemming from radiotherapy.…”

Review of Under-Recognized Adjunctive Therapies for Cancer

“…An inverse relationship between statin use and the incidence of head and neck cancer was found in an analysis of a large population data base in Taiwan [136]. Bourguillon et al concluded that statins may be beneficial by reducing side effects from chemotherapy/radiotherapy and improving survival based on the results of HNC trials [137]. A 2020 review by Matusewicz et al [138] suggested that statins may be beneficial for treating metastatic cancers, due to their inhibition of the epithelial-mesenchymal transition.…”