Statin Use in Patients With Cancer: Drug Interaction and Statin Usage

Cardiovascular disease and cancer share common risk factors. Statins, which are widely prescribed for cardiovascular disease prevention, have potential for drug-drug interactions (DDIs) with oncology agents.

This study quantifies and characterizes interactions between statins and recently approved oncology agents. Additionally, the study evaluates statin prescribing trends in patients with cancer.

Food and Drug Administration oncology drug approvals from June 2019 to June 2024 were screened for interactions with 5 commonly prescribed statins using UpToDate Lexidrug. Interaction severity was classified into 5 risk levels. Statin prescribing rates, stratified by cancer type, were characterized through a scoping review of 20 PubMed-indexed observational studies.

Of 138 oncology agents, 33 (23.9%) exhibited DDIs with statins. Simvastatin demonstrated the highest interaction rate (22% [30/138] of oncology drugs), while pravastatin had the fewest (4% [5/138] oncology drugs). Most interactions (88%, 71/81) were classified as level C, requiring monitoring. Contraindicated interactions (level X) were identified for adagrasib, tucatinib, and asciminib. Across the 23,3774 patients in the included studies, statin use was most common in prostate (53%, 57,926/109,140 of patients) and lung cancer (32%, 1,403/4,344), and least common in liver (8%, 3,100/39,722) and breast cancer (10%, 1,519/15,078).

Statin-oncology agent DDIs are relatively common but rarely is statin use contraindicated. Frequency of statins use varies according to cancer type. These findings highlight the importance of individualized risk-benefit assessments that consider prognosis, cardiovascular risk, potential drug interactions, and patient preferences to guide statin use in cancer patients.