Statins to reduce renal sinus fat among breast cancer patients undergoing anthracycline-based chemotherapy: A substudy of PREVENT-WF-98213.

Abstract

To test if statin administration attenuated renal sinus fat (RSF) accumulation and if RSF was associated with renal function in women with breast cancer (BC) receiving anthracycline-based chemotherapy. This was a secondary analysis in a subgroup of women with stage I-III BC randomized to placebo (n = 35) or statin (40 mg/day atorvastatin, n = 44) therapy. At baseline and 24-months after randomization, RSF and intraabdominal fat were measured from magnetic resonance images, and estimated glomerular filtration rate (eGFR) was calculated from serum creatinine. Participants in this study averaged 51 years of age (SD 11), 87% reported White race, and had a mean BMI (±SD) of 30.2 kg/m2 (±6.1). Most participants (60%) were diagnosed with stage II BC. At 24-months, RSF was higher in the placebo group relative to the statin group (β [95% CI], p-value: 0.17 [0.009, 0.34], p = 0.04). After adjusting for baseline RSF, this signal remained but was attenuated (β [95% CI], p-value: 0.12 [-0.06, 0.29], p = 0.18). In all participants at baseline and prior to beginning chemotherapy for BC or study drug, higher RSF was associated with lower eGFR values in all participants (r = -0.23, p = 0.03). At 24-months by study group, greater RSF was associated with decreased eGFR in the placebo group (-0.51, p = 0.01) but not in the statin group (-0.25, p = 0.19). Statin administration may lower RSF during anthracycline-based chemotherapy. These findings merit further investigation to determine if statins protect renal function during BC treatment.