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World J Clin Cases. Jun 26, 2021; 9(18): 4500-4505
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4500
Anti-tumor effect of statin on pancreatic adenocarcinoma: From concept to precision medicine
Chung-Tsui Huang, Yao-Jen Liang
Chung-Tsui Huang, Department of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei 220, Taiwan
Yao-Jen Liang, Graduate Institute of Applied Science and Engineering, Department and Institute of Life Science, Fu-Jen University, New Taipei 242, Taiwan
Author contributions: Huang CT wrote the manuscript; Liang YJ contributed to teaching physician Huang CT regarding the idea, title and how to research papers for the review article.
Conflict-of-interest statement: There is no conflict of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yao-Jen Liang, PhD, Professor, Graduate Institute of Applied Science and Engineering, Department and Institute of Life Science, Fu-Jen University, No. 510 Zhongzheng Road, Xinzhuang District, New Taipei 242, Taiwan. 071558@mail.fju.edu.tw
Received: January 27, 2021
Peer-review started: January 27, 2021
First decision: February 27, 2021
Revised: March 11, 2021
Accepted: March 31, 2021
Article in press: March 31, 2021
Published online: June 26, 2021
Processing time: 135 Days and 8.2 Hours
Abstract

A statin is a cholesterol-lowering agent, which inhibits HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase and subsequently reduces the cholesterol precursor, and was first used commercially in 1987. The concept of cholesterol restriction leading to cancer cell dysfunction was proposed in 1992. The interruption of different signaling pathways has been proved in preclinical experiments to elucidate the anti-tumor mechanism of statins in pancreatic adenocarcinoma. Observational studies have shown that the clinical use of statins is beneficial in patients with pancreatic adenocarcinoma, including a chemoprevention effect, post-surgical resection follow-up and therapeutic prognosis of advanced cancer stage. Arrest of the cancer cell cycle by the combined use of gemcitabine and statin was observed in a cell line study. The effect of microbiota on the tumor microenvironment of pancreatic adenocarcinoma is a new therapeutic approach as statins can modulate the gut microbiota. Hence, further randomized trials of statins in pancreatic adenocarcinoma treatment will be warranted with application of precision medicine from microbiota-derived, cell cycle-based and signaling pathway-targeted research.

Keywords: Statin; Pancreatic cancer; Precision medicine; Anti-tumor; Pancreatic adenocarcinoma

Core Tip: A statin is a cholesterol-lowering agent, which inhibits HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase and subsequently reduces the cholesterol precursor, and was first used commercially in 1987. This is a mini-review of statin use in pancreatic adenocarcinoma, focusing on the therapeutic effect. A search of relevant literature from 1992 to 2021 was conducted. The effect of microbiota on the tumor microenvironment of pancreatic adenocarcinoma is a new therapeutic approach as statins can modulate the gut microbiota.