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Mevalonate signaling, COPD and cancer: the statins and beyond

Raewyn J Hopkins, Robert P Young
DOI: 10.1136/jim-2018-000829 Published 26 March 2019
Raewyn J Hopkins
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Robert P Young
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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    Figure 1

    Proposed relationship between the mevalonate pathway, smoking, chronic obstructive pulmonary disease and lung cancer.

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    Figure 2

    Absolute rates of lung cancer incidence and mortality in the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS)7 relative to lung cancer incidence during the follow-up interval 3–4 years of the NLST* CXR arm. CXR, chest X-ray; NLST*, National Lung Screening Trial is the largest lung cancer screening trial to date and reported a 20% reduction in lung cancer mortality through the identification and surgical treatment of early stage non-small cell cancer. Over the same duration of follow-up in the CXR arm of the NLST, we found a comparable incidence of lung cancer to that in the placebo arm of CANTOS (1.61% and 1.82% respectively).34

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    A comparison of observed minus expected outcomes in relation to cause-specific mortality (data sourced from Ridker et al 7)

    Cause of deathDeaths in placebo*
    (n=3344 total)
    Death in treated
    (n=6717 total)
    Expected deaths†Observed-expected
    (difference [%])
    Lung cancer383977−38 (−49)
    Other cancers437686−10 (−12)
    Sepsis237846+32 (+70)
    Cardiovascular182319366−47 (−13)
    Other/unknown89193178+15 (+8)
    Total375705753−48
    • †The absolute number of expected deaths in the treated arm were calculated according to deaths in the placebo arm*. These were estimated to be approximately twofold that in the placebo arm.7

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Vol 67 Issue 4 Table of Contents
Journal of Investigative Medicine: 67 (4)
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Mevalonate signaling, COPD and cancer: the statins and beyond
Raewyn J Hopkins, Robert P Young
Journal of Investigative Medicine Apr 2019, 67 (4) 711-714; DOI: 10.1136/jim-2018-000829

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Mevalonate signaling, COPD and cancer: the statins and beyond
Raewyn J Hopkins, Robert P Young
Journal of Investigative Medicine Apr 2019, 67 (4) 711-714; DOI: 10.1136/jim-2018-000829
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Mevalonate signaling, COPD and cancer: the statins and beyond
Raewyn J Hopkins, Robert P Young
Journal of Investigative Medicine Apr 2019, 67 (4) 711-714; DOI: 10.1136/jim-2018-000829
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