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Gastrointestinal cancer
A Phase II Study of Preoperative Chemoradiotherapy with Capecitabine Plus Simvastatin in Patients with Locally Advanced Rectal Cancer
Hyunji Jo, Seung Tae Kim, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Jeong Il Yu, Hee Chul Park, Doo Ho Choi, Yoonah Park, Yong Beom Cho, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Won Ki Kang
Cancer Res Treat. 2023;55(1):189-195.   Published online June 8, 2022
DOI: https://doi.org/10.4143/crt.2021.1527
AbstractAbstract PDFPubReaderePub
Purpose
The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC).
Materials and Methods
Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity.
Results
Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin.
Conclusion
The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

Citations

Citations to this article as recorded by  
  • Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy for locally advanced rectal cancer: an updated meta-analysis
    Yue Guo, Zhifeng Guo, Jiaojiao Zhang, Guowu Qian, Wangquan Ji, Linlin Song, Zhe Guo, Zhuo Han
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • A randomized phase II/III trial of rosuvastatin with neoadjuvant chemo-radiation in patients with locally advanced rectal cancer
    Prachi S. Patil, Avanish Saklani, Naveena A. N. Kumar, Ashwin De’Souza, Rahul Krishnatry, Snehal Khanvilkar, Mufaddal Kazi, Reena Engineer, Vikas Ostwal, Anant Ramaswamy, Munita Bal, Priya Ranganathan, Ekta Gupta, Sanjeev Galande
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Effects of Hyperlipidemia on Osseointegration of Dental Implants and Its Strategies
    Haiyang Sun, Shuhuai Meng, Junyu Chen, Qianbing Wan
    Journal of Functional Biomaterials.2023; 14(4): 194.     CrossRef
  • 5,953 View
  • 167 Download
  • 3 Web of Science
  • 3 Crossref
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Breast Cancer
Combination of Simvastatin and FAC Improves Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer
Erwin Danil Yulian, Nurjati Chairani Siregar, Bajuadji
Cancer Res Treat. 2021;53(4):1072-1083.   Published online March 9, 2021
DOI: https://doi.org/10.4143/crt.2020.1024
AbstractAbstract PDFPubReaderePub
Purpose
The efficacy of neoadjuvant chemotherapy for locally advanced breast cancer (LABC) is limited due to drug resistance and cardiotoxic effects. Preclinical studies have shown that statin induces apoptosis and decreases breast cancer cell growth. This study aims to evaluate the role of statin in combination with fluorouracil, adriamycin, and cyclophosphamide (FAC) therapy in LABC patients.
Materials and Methods
We undertook a randomized, double-blinded, placebo-controlled trial in two centers of Indonesia. Patients were randomly assigned to FAC plus simvastatin (40 mg/day orally) or FAC plus placebo (40 mg/day) for 21 days. The FAC regimen was repeated every 3 weeks. We evaluated the clinical response, pathological response, and toxicities.
Results
The objective response rate (ORR) for FAC plus simvastatin was 90% (95% confidence interval [CI], 0.99 to 1.67) by per-protocol analysis. No complete responses (CR) were recorded, but there were 48 partial responses. No significant difference was observed between the two groups with the ORR (p=0.103). The pathological CR rate was 6.25% (2 in simvastatin group and 1 in placebo group). Adverse events in both arms were generally mild, mainly consisted of myotoxicity. Human epidermal growth factor receptor 2 (HER2) expression was a factor related to the success of therapeutic response (odds ratio, 4.2; 95% CI, 1.121 to 15.731; p=0.033).
Conclusion
This study suggests that simvastatin combined with FAC shows improvements in ORR and pathological response in patients with LABC. Although no statistically significant difference was documented, there was a trend for better activity and tolerability. The addition of 40 mg simvastatin may improve the efficacy of FAC in LABC patients with HER2 overexpression.

Citations

Citations to this article as recorded by  
  • Theoretical framework and emerging challenges of lipid metabolism in cancer
    Qiuying Gu, Yuan Wang, Ping Yi, Chunming Cheng
    Seminars in Cancer Biology.2025; 108: 48.     CrossRef
  • Clinical significance of lipid pathway-targeted therapy in breast cancer
    Dan Li, Pengcheng Jin, Yiqi Cai, Shijie Wu, Xianan Guo, Zhiyun Zhang, Kexin Liu, Panni Li, Yue Hu, Yunxiang Zhou
    Frontiers in Pharmacology.2025;[Epub]     CrossRef
  • Anticancer properties of histone deacetylase inhibitors – what is their potential?
    Kajetan Kiełbowski, Agata Szwedkowicz, Paulina Plewa, Estera Bakinowska, Rafał Becht, Andrzej Pawlik
    Expert Review of Anticancer Therapy.2025; 25(2): 105.     CrossRef
  • Divide and Conquer—Targeted Therapy for Triple-Negative Breast Cancer
    Milica Nedeljković, Ana Vuletić, Katarina Mirjačić Martinović
    International Journal of Molecular Sciences.2025; 26(4): 1396.     CrossRef
  • Factors Affecting Pathological Complete Response in Locally Advanced Breast Cancer Cases Receiving Neoadjuvant Therapy: A Comprehensive Literature Review
    Munaser Alamoodi
    European Journal of Breast Health.2024; 20(1): 8.     CrossRef
  • Role of hydroxymethylglutharyl-coenzyme A reductase in the induction of stem-like states in breast cancer
    María Paula Marks, Carla Alejandra Giménez, Luciana Isaja, Mariana Belén Vera, Francisco Raúl Borzone, Federico Pereyra-Bonnet, Leonardo Romorini, Guillermo Agustín Videla-Richardson, Norma Alejandra Chasseing, Juan Carlos Calvo, Luciano Vellón
    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
  • Cardiovascular/anti‐inflammatory drugs repurposed for treating or preventing cancer: A systematic review and meta‐analysis of randomized trials
    David J. Benjamin, Alyson Haslam, Vinay Prasad
    Cancer Medicine.2024;[Epub]     CrossRef
  • Are statins onco- suppressive agents for every type of tumor? A systematic review of literature
    Luca Filaferro, Fabiana Zaccarelli, Giovanni Francesco Niccolini, Andrea Colizza, Federica Zoccali, Michele Grasso, Massimo Fusconi
    Expert Review of Anticancer Therapy.2024; 24(6): 435.     CrossRef
  • Post-surgery statin use contributes to favorable outcomes in patients with early breast cancer
    María Belén Giorello, María Paula Marks, Tiago Martín Osinalde, María del Rosario Padin, Alejandra Wernicke, Juan Carlos Calvo, Norma Alejandra Chasseing, Luciano Vellón
    Cancer Epidemiology.2024; 90: 102573.     CrossRef
  • Unraveling the intricate relationship between lipid metabolism and oncogenic signaling pathways
    Fahad Khan, Deena Elsori, Meenakshi Verma, Shivam Pandey, Safia Obaidur Rab, Samra Siddiqui, Nadiyah M. Alabdallah, Mohd Saeed, Pratibha Pandey
    Frontiers in Cell and Developmental Biology.2024;[Epub]     CrossRef
  • Obesity-Associated Colorectal Cancer
    Lucia Gonzalez-Gutierrez, Omar Motiño, Daniel Barriuso, Juan de la Puente-Aldea, Lucia Alvarez-Frutos, Guido Kroemer, Roberto Palacios-Ramirez, Laura Senovilla
    International Journal of Molecular Sciences.2024; 25(16): 8836.     CrossRef
  • Statins inhibit paclitaxel-induced PD-L1 expression and increase CD8+ T cytotoxicity for better prognosis in breast cancer
    Lei Li, Hongbin Wang, Shiyuan Zhang, Song Gao, Xiuxin Lu, You Pan, Wei Tang, Rong Huang, Kun Qiao, Shipeng Ning
    International Journal of Surgery.2024; 110(8): 4716.     CrossRef
  • Geranylgeranyl diphosphate synthase: Role in human health, disease and potential therapeutic target
    Molly E. Muehlebach, Sarah A. Holstein
    Clinical and Translational Medicine.2023;[Epub]     CrossRef
  • The role of HMGCR expression in combination therapy of simvastatin and FAC treated locally advanced breast cancer patients
    Erwin Danil Yulian, Nurjati Chairani Siregar, Bajuadji Sudijono, Lie Rebecca Yen Hwei
    Breast Disease.2023; 42(1): 73.     CrossRef
  • A phase 1 study of simvastatin in combination with topotecan and cyclophosphamide in pediatric patients with relapsed and/or refractory solid and CNS tumors
    Thomas Cash, Hunter C. Jonus, Maya Tsvetkova, Jan H. Beumer, Arhanti Sadanand, Jasmine Y. Lee, Curtis J. Henry, Dolly Aguilera, R. Donald Harvey, Kelly C. Goldsmith
    Pediatric Blood & Cancer.2023;[Epub]     CrossRef
  • New insights into the therapeutic potentials of statins in cancer
    Chengyu Liu, Hong Chen, Bicheng Hu, Jiajian Shi, Yuchen Chen, Kun Huang
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • Lipid metabolic reprogramming in tumor microenvironment: from mechanisms to therapeutics
    Hao-Ran Jin, Jin Wang, Zi-Jing Wang, Ming-Jia Xi, Bi-Han Xia, Kai Deng, Jin-Lin Yang
    Journal of Hematology & Oncology.2023;[Epub]     CrossRef
  • Repositioning of HMG-CoA Reductase Inhibitors as Adjuvants in the Modulation of Efflux Pump-Mediated Bacterial and Tumor Resistance
    Zsuzsanna Schelz, Hiba F. Muddather, István Zupkó
    Antibiotics.2023; 12(9): 1468.     CrossRef
  • Dysregulation of cholesterol metabolism in cancer progression
    Xuesong Liu, Mengzhu Lv, Weimin Zhang, Qimin Zhan
    Oncogene.2023; 42(45): 3289.     CrossRef
  • p140Cap modulates the mevalonate pathway decreasing cell migration and enhancing drug sensitivity in breast cancer cells
    Giorgia Centonze, Dora Natalini, Silvia Grasso, Alessandro Morellato, Vincenzo Salemme, Alessio Piccolantonio, Giacomo D’Attanasio, Aurora Savino, Olga Teresa Bianciotto, Matteo Fragomeni, Andrea Scavuzzo, Matteo Poncina, Francesca Nigrelli, Mario De Greg
    Cell Death & Disease.2023;[Epub]     CrossRef
  • Beyond Lipid-Lowering: Effects of Statins on Cardiovascular and Cerebrovascular Diseases and Cancer
    Yoichi Morofuji, Shinsuke Nakagawa, Kenta Ujifuku, Takashi Fujimoto, Kaishi Otsuka, Masami Niwa, Keisuke Tsutsumi
    Pharmaceuticals.2022; 15(2): 151.     CrossRef
  • Long-term effectiveness of empiric cardio-protection in patients receiving cardiotoxic chemotherapies: A systematic review & bayesian network meta-analysis
    Ahmed Sayed, Omar M. Abdelfattah, Malak Munir, Omar Shazly, Ahmed K. Awad, Hazem S. Ghaith, Khaled Moustafa, Maria Gerew, Avirup Guha, Ana Barac, Michael G. Fradley, George S. Abela, Daniel Addison
    European Journal of Cancer.2022; 169: 82.     CrossRef
  • Simvastatin in the Treatment of Colorectal Cancer: A Review
    Hongliang Zang, Wei Yang, Xiaofeng Tian, Tian Jiao Wang
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
  • Mutant p53, the Mevalonate Pathway and the Tumor Microenvironment Regulate Tumor Response to Statin Therapy
    Madison Pereira, Kathy Matuszewska, Alice Glogova, Jim Petrik
    Cancers.2022; 14(14): 3500.     CrossRef
  • Repurposing of metabolic drugs and mitochondrial modulators as an emerging class of cancer therapeutics with a special focus on breast cancer
    Versha Tripathi, Pooja Jaiswal, Khageswar Sahu, Shovan Kumar Majumder, Dharmendra Kashyap, Hem Chandra Jha, Amit Kumar Dixit, Hamendra Singh Parmar
    Advances in Cancer Biology - Metastasis.2022; 6: 100065.     CrossRef
  • Repurposing of Metabolic Drugs and Mitochondrial Modulators as an Emerging Class of Cancer Therapeutics with a Special Focus on Breast Cancer
    Hamendra Singh Singh Parmar, Versha Tripathi, Pooja Jaiswal, Khageshwar Sahu, Shovan Kumar Majumder, Dharmendra Kashyap, Amit Kumar Dixit, Hem Chandra Jha
    SSRN Electronic Journal .2022;[Epub]     CrossRef
  • Statins: a repurposed drug to fight cancer
    Wen Jiang, Jin-Wei Hu, Xu-Ran He, Wei-Lin Jin, Xin-Yang He
    Journal of Experimental & Clinical Cancer Research.2021;[Epub]     CrossRef
  • 10,681 View
  • 183 Download
  • 27 Web of Science
  • 27 Crossref
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A Single Arm, Phase II Study of Simvastatin Plus XELOX and Bevacizumab as First-Line Chemotherapy in Metastatic Colorectal Cancer Patients
Youjin Kim, Tae Won Kim, Sae Won Han, Joong Bae Ahn, Seung Tae Kim, Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang
Cancer Res Treat. 2019;51(3):1128-1134.   Published online November 21, 2018
DOI: https://doi.org/10.4143/crt.2018.379
AbstractAbstract PDFPubReaderePub
Purpose
Simvastatin has demonstrated anti-tumor activity in preclinical studies via tumor cell senescence, apoptosis, and anti-angiogenesis. This phase II trial evaluated the efficacy and toxicity profile of conventional XELOX and bevacizumab chemotherapy plus simvastatin in metastatic colorectal cancer patients (MCRC).
Materials and Methods
Patients with MCRC received first-line XELOX in 3-week treatment cycles of intravenous oxaliplatin 130 mg/m2 plus bevacizumab 7.5 mg/kg (day 1), followed by oral capecitabine 1,000 mg/m2 twice daily (day 1-14). Simvastatin 80 mg tablets were taken orally once daily every day during the period of chemotherapy. The primary endpoint was progression-free survival (PFS). Secondary endpoints were response rate, duration of response, overall survival (OS), time to progression, and toxicity.
Results
From January 2014 to April 2015, 60 patients were enrolled and 55 patients were evaluable for tumor response. The median follow-up duration was 30.1 months (range, 28.5 to 31.7 months). The median PFS was 10.4 months (95% confidence interval [CI], 9.6 to 11.1). The median OS of all patients was 19.0 months (95% CI, 11.9 to 26.0). The disease-control rate and overall response rate were 88.3% (95% CI, 74 to 96) and 58.3% (95% CI, 44 to 77), respectively, by intent-to-treat protocol analysis. There was one complete response and 34 partial responses. One patient experienced grade 3 creatine kinase elevation and liver enzyme elevation.
Conclusion
Based on the current study, the addition of 80 mg simvastatin to XELOX and bevacizumab showed comparable clinical efficacy in patients with MCRC as first-line chemotherapy and did not increase toxicity.

Citations

Citations to this article as recorded by  
  • Anticancer properties of histone deacetylase inhibitors – what is their potential?
    Kajetan Kiełbowski, Agata Szwedkowicz, Paulina Plewa, Estera Bakinowska, Rafał Becht, Andrzej Pawlik
    Expert Review of Anticancer Therapy.2025; 25(2): 105.     CrossRef
  • Therapeutic Effects of Statins: Promising Drug for Topical and Transdermal Administration
    Fatemeh Zahedipour, Seyede Atefe Hosseini, Željko Reiner, Eugenia Tedeschi-Reiner, Tannaz Jamialahmadi, Amirhossein Sahebkar
    Current Medicinal Chemistry.2024; 31(21): 3149.     CrossRef
  • Are statins onco- suppressive agents for every type of tumor? A systematic review of literature
    Luca Filaferro, Fabiana Zaccarelli, Giovanni Francesco Niccolini, Andrea Colizza, Federica Zoccali, Michele Grasso, Massimo Fusconi
    Expert Review of Anticancer Therapy.2024; 24(6): 435.     CrossRef
  • Cholesterol synthesis is essential for the growth of liver metastasis‐prone colorectal cancer cells
    Kumiko Taniguchi, Kei Sugihara, Takashi Miura, Daisuke Hoshi, Susumu Kohno, Chiaki Takahashi, Eishu Hirata, Etsuko Kiyokawa
    Cancer Science.2024; 115(11): 3817.     CrossRef
  • Statins in Mitigating Anticancer Treatment-Related Cardiovascular Disease
    Rong Jiang, Lian Lou, Wen Shi, Yuxiao Chen, Zhaoming Fu, Shuo Liu, Thida Sok, Zhihang Li, Xuan Zhang, Jian Yang
    International Journal of Molecular Sciences.2024; 25(18): 10177.     CrossRef
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    Thomas Cash, Hunter C. Jonus, Maya Tsvetkova, Jan H. Beumer, Arhanti Sadanand, Jasmine Y. Lee, Curtis J. Henry, Dolly Aguilera, R. Donald Harvey, Kelly C. Goldsmith
    Pediatric Blood & Cancer.2023;[Epub]     CrossRef
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    Chengyu Liu, Hong Chen, Bicheng Hu, Jiajian Shi, Yuchen Chen, Kun Huang
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • The Association of Metformin, Other Antidiabetic Medications, and Statins With the Prognosis of Colon Cancer in Patients With Type 2 Diabetes: A Retrospective Cohort Study
    Sami Erkinantti, Ari Hautakoski, Reijo Sund, Martti Arffman, Elina Urpilainen, Ulla Puistola, Arja Jukkola, Karihtala Peeter, Esa Läärä
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    Jaqueline Aparecida Duarte, Andre Luis Branco de Barros, Elaine Amaral Leite
    Biomedicine & Pharmacotherapy.2021; 141: 111858.     CrossRef
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    Navneet Kumar, Chandi C. Mandal
    Frontiers in Genetics.2021;[Epub]     CrossRef
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    Shangwei Zhong, Changhao Huang, Zhikang Chen, Zihua Chen, Jun-Li Luo
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  • 18 Web of Science
  • 14 Crossref
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Synergistic Effect of Sulindac and Simvastatin on Apoptosis in Lung Cancer A549 Cells through AKT-Dependent Downregulation of Survivin
Young-Suk Kim, Chang-Hwan Seol, Jae-Wan Jung, Su-Jin Oh, Ki-Eun Hwang, Hwi-Jung Kim, Eun-Taik Jeong, Hak-Ryul Kim
Cancer Res Treat. 2015;47(1):90-100.   Published online October 27, 2014
DOI: https://doi.org/10.4143/crt.2013.194
AbstractAbstract PDFPubReaderePub
Purpose
Non-steroidal anti-inflammatory drugs (NSAIDs) and statins are potential chemopreventive or chemotherapeutic agents. The mechanism underlying the deregulation of survivin by NSAIDs and statins in human non-small cell lung cancer cells has not been elucidated. In this study, we investigated the synergistic interaction of sulindac and simvastatin in lung cancer A549 cells.
Materials and Methods
Cell viability was measured by an MTT assay, while the expression of apoptotic markers, AKT, and survivin in response to sulindac and simvastatin was examined by Western blotting. DNA fragmentation by apoptosis was analyzed by flow cytometry in A549 cells. Reactive oxygen species (ROS) generation was measured by flow cytometry using H2DCFDA and MitoSOX Red, and the effects of pretreatment with N-acetylcysteine were tested. The effects of AKT on survivin expression in sulindac- and simvastatin-treated cells were assessed. Survivin was knocked down or overexpressed to determine its role in apoptosis induced by sulindac and simvastatin.
Results
Sulindac and simvastatin synergistically augmented apoptotic activity and intracellular ROS production in A549 cells. Inhibition of AKT by siRNA or LY294002 inhibited survivin, while AKT overexpression markedly increased survivin expression, even in the presence of sulindac and simvastatin. Moreover, survivin siRNA enhanced sulindac- and simvastatininduced apoptosis. In contrast, survivin upregulation protected against sulindac- and simvastatin-induced apoptosis.
Conclusion
Combined treatment with sulindac and simvastatin augmented their apoptotic potential in lung cancer cells through AKT signaling-dependent downregulation of survivin. These results indicate that sulindac and simvastatin may be clinically promising therapies for the prevention of lung cancer.

Citations

Citations to this article as recorded by  
  • Regulatory effects of statins on Akt signaling for prevention of cancers
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    Cellular Signalling.2024; 120: 111213.     CrossRef
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    Frontiers in Genetics.2021;[Epub]     CrossRef
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  • 15,433 View
  • 127 Download
  • 15 Web of Science
  • 11 Crossref
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