Statin Applications in Colorectal Cancer Prognosis

Statins, or HMG-CoA reductase inhibitors, have emerged as potential adjuncts in colorectal cancer management, extending beyond lipid-lowering to modulate tumour biology. Preclinical and clinical investigations suggest that statins may enhance chemosensitivity, mitigate chemoradiotherapy toxicity and improve long-term survival. Mechanistically, these agents interfere with isoprenoid synthesis required for small G-protein prenylation, notably affecting KRAS-driven signalling, while also promoting apoptosis, modulating inflammatory pathways and augmenting antitumour immune responses. Observational studies indicate that ongoing statin therapy at the time of surgery correlates with reduced postoperative mortality, and early-phase trials in rectal cancer hint at improved tumour regression when statins are combined with standard chemoradiation. Collectively, evidence supports a multifaceted role for statins in refining prognostic outcomes in colorectal cancer, warranting further randomised evaluation.

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Statin Applications in Colorectal Cancer Prognosis publication trend

The graph below shows the total number of articles in statin applications in colorectal cancer prognosis across all publications each year (not limited to Nature Index journals).

Technical terms

Statins: A class of drugs that inhibit HMG-CoA reductase, reducing cholesterol synthesis and affecting isoprenoid intermediates involved in cell signalling.

KRAS mutation: A genetic alteration in the KRAS oncogene that leads to constitutive activation of downstream proliferative pathways in colorectal cancer.

Prenylation: A post-translational lipid modification of proteins, including RAS family members, essential for membrane localization and signalling.

Apoptosis: Programmed cell death characterised by caspase activation and DNA fragmentation, often targeted to eliminate cancer cells.

mrTRG (MRI-based tumour regression grading): A non-invasive radiological assessment of rectal tumour response to neoadjuvant therapy, scored on a scale correlating with pathological regression.

All-cause mortality: The rate of death from any cause during a defined follow-up period, used as a primary endpoint in survival analyses.

Cancer-specific survival: The proportion of patients who have not died from colorectal cancer during a specified time, isolating disease-related mortality.

References

1. Statins enhances antitumor effect of oxaliplatin in KRAS-mutated colorectal cancer cells and inhibits oxaliplatin-induced neuropathy. Cancer Cell International (2023).
2. SPAR – a randomised, placebo-controlled phase II trial of simvastatin in addition to standard chemotherapy and radiation in preoperative treatment for rectal cancer: an AGITG clinical trial. BMC Cancer (2019).
3. Statin therapy and its association with long-term survival after colon cancer surgery. Surgery (2021).