Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2022; 14(1): 110-123
Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.110
Statin as a therapeutic agent in gastroenterological cancer
Norio Uemura, Hiromitsu Hayashi, Hideo Baba
Norio Uemura, Hiromitsu Hayashi, Hideo Baba, Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
Author contributions: Uemura N and Hayashi H contributed equally to this work; Uemura N, Hayashi H and Baba H designed the research study; Uemura N and Hayashi H performed the research, analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: Authors have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiromitsu Hayashi, FACS, MD, PhD, Surgeon, Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. hhayasi@kumamoto-u.ac.jp
Received: April 29, 2021
Peer-review started: April 29, 2021
First decision: June 6, 2021
Revised: June 19, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 15, 2022
Abstract

Statins inhibit 3-hydroxy-3-methylglutaryl-CoA reductase, the rate-limiting enzyme of the mevalonate pathway, and are widely used as an effective and safe approach handle hypercholesterolemia. The mevalonate pathway is a vital metabolic pathway that uses acetyl-CoA to generate isoprenoids and sterols that are crucial to tumor growth and progression. Multiple studies have indicated that statins improve patient prognosis in various carcinomas. Basic research on the mechanisms underlying the antitumor effects of statins is underway. The development of new anti-cancer drugs is progressing, but increasing medical costs from drug development have become a major obstacle. Readily available, inexpensive and well-tolerated drugs like statins have not yet been successfully repurposed for cancer treatment. Identifying the cancer patients that may benefit from statins is key to improved patient treatment. This review summarizes recent advances in statin research in cancer and suggests important considerations for the clinical use of statins to improve outcomes for cancer patients.

Keywords: Statin, HMG CoA reductase inhibitor, Mevalonate pathway, Cancer

Core Tip: Novel pharmacological therapies for cancer are in development, but the expense of new drug development has increased medical costs and placed a heavy financial burden on governments worldwide. Therefore, drug repositioning has become a major focus for new drug development because of reliability and cost effectiveness. Statins are one of the most studied drugs with potential drug repositioning for cancer treatment, but they have not reached clinical application. This review summarizes the results of recent research and clinical studies of statins in cancer, suggests strategies for clinical trial planning, and discusses the potential clinical application of statins for cancer treatment.