Recently, many studies have reported the relationship between drugs and the response and survival of patients with non-small cell lung cancer (NSCLC) receiving tumor immunotherapy. However, the clinical effect of statins on tumor immunotherapy in patients with NSCLC remains unclear. Recently, relevant results were published in the journal BMC cancer to evaluate the clinical effect of statins on PD-1 inhibitor monotherapy in patients with advanced NSCLC.
The study included 390 patients with advanced or recurrent NSCLC who received PD-1 inhibitor monotherapy in 3 medical centers in Japan from January 2016 to December 2019. To evaluate the impact of statins on their survival, propensity matching score was used to reduce the impact of confounding factors.
Among the 390 patients, the median age was 67 years (range 31-88 years), of which 309 (79.2%) were male. Among the 390 patients, 53 (13.6%) received statins, including 12 atorvastatin, 10 pivastatin, 9 pravastatin, 19 rosuvastatin and 3 simvastatin. 326 patients had EGFR or ALK status data (83.6%), and 261 patients had PD-L1 data (66.9%).
Kaplan Meier curve showed that there was no significant difference in PFS or OS between patients receiving and not receiving statins (p=0.4777, p=0.5264); Multivariate analysis showed that ECoG PS (PS 1-3 vs PS 0: hr=1.36, p=0.0084), smoking history (never smoking vs. smokers: hr=1.37, p=0.0298) and PD-L1 expression status (others vs. TPS ≥ 50%:hr=1.64, p<0.0001) were independent prognostic factors for PFS, while ECoG PS (PS 1-3 vs PS 0: hr=1.66, p=0.0001) and PD-L1 expression status (others vs TPS ≥ 50%: hr=1.52, p=0.0026) were independent prognostic factors for OS.
After using the propensity matching score, there were 45 patients in each group. The Kaplan Meier curve showed that patients receiving statins had a longer OS (P = 0.0433) than patients not receiving statins, but there was no difference in PFS (P = 0.2251).
Cox regression analysis of the propensity score matched cohort showed that statin use was not an independent prognostic factor, although it tended to be associated with a favorable prognosis (use vs. not use: hr=0.61, p=0.0585).
In conclusion, studies have shown that statins may increase the efficacy of immunotherapy in NSCLC. However, a prospective study with a larger sample size is needed for further verification.
Original source:
Takada K, Shimokawa M, Takamori S, Shimamatsu S, Hirai F, Tagawa T, Okamoto T, Hamatake M, Tsuchiya-Kawano Y, Otsubo K, Inoue K, Yoneshima Y, Tanaka K, Okamoto I, Nakanishi Y, Mori M. A propensity score-matched analysis of the impact of statin therapy on the outcomes of patients with non-small-cell lung cancer receiving anti-PD-1 monotherapy: a multicenter retrospective study. BMC Cancer. 2022 May 6; 22(1):503. doi: 10.1186/s12885-022-09385-8. PMID: 35524214; PMCID: PMC9074359.
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