Research Papers:

Simvastatin-induced breast cancer cell death and deactivation of PI3K/Akt and MAPK/ERK signalling are reversed by metabolic products of the mevalonate pathway

Tingting Wang, Serena Seah, Xinyi Loh, Ching-Wan Chan, Mikael Hartman, Boon-Cher Goh and Soo-Chin Lee _

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Oncotarget. 2016; 7:2532-2544. https://doi.org/10.18632/oncotarget.6304

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Tingting Wang1, Serena Seah1, Xinyi Loh1, Ching-Wan Chan3, Mikael Hartman3, Boon-Cher Goh1,2 and Soo-Chin Lee1,2

1 Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore

2 Department of Haematology and Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore

3 Department of Surgery, National University Cancer Institute, National University Health System, Singapore, Singapore

Correspondence to:

Soo-Chin Lee, email:

Keywords: simvastatin, PI3K/Akt/mTOR, MAPK/ERK, mevalonate pathway, breast cancer

Received: May 15, 2015 Accepted: October 14, 2015 Published: November 11, 2015


Statins purportedly exert anti-tumoral effects on breast cancer. However, the biologic mechanisms for these actions are not fully elucidated. The aims of this study were 1) to explore the effects of simvastatin on apoptosis, proliferation as well as PI3K/Akt/mTOR and MAPK/ERK pathway in a window-of-opportunity breast cancer trial; 2) to further confirm findings from the clinical trial by functional studies; 3) to explore the regulatory role of mevalonate pathway on the anti-tumoral effects of simvastatin. In clinical samples, simvastatin led to increase in cleaved caspase-3 (p = 0.002) and decreased trend for Ki67 (p = 0.245). Simvastatin markedly suppressed PI3K/Akt/mTOR signalling by activating PTEN (p = 0.005) and by dephosphorylating Akt (p = 0.002) and S6RP (p = 0.033); it also inhibited MAPK/ERK pathway by dephosphorylating c-Raf (p = 0.018) and ERK1/2 (p = 0.002). In ER-positive (MCF-7, T47D) and ER-negative (MDA-MB-231, BT-549) breast cancer cells, simvastatin treatment consistently induced apoptosis and inhibited proliferation by deregulating caspase cascades and cell cycle proteins in a dose dependent manner. Concordantly, simvastatin strongly suppressed PI3K/Akt/mTOR pathway by enhancing PTEN expression and by further sequentially dephosphorylating downstream cascades including Akt, mTOR, p70S6K, S6RP and 4E-BP1. Furthermore, simvastatin significantly inhibited MAPK/ERK pathway by dephosphorylating sequential cascades such as c-Raf, MEK1/2 and ERK1/2. These simvastatin anti-tumoral effects were reversed by metabolic products of the mevalonate pathway, including mevalonate, farnesyl pyrophosphate and geranylgeranyl pyrophosphate. These findings shed light on the biological and potential anti-tumoral effects of simvastatin in breast cancer.

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