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Statins may lower mortality risk in patients with lung cancer
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Statin use in the year before and after diagnosis was linked to decreased mortality risk in patients with lung cancer, according to results of a population-based cohort study.
Using the statin simvastatin was particularly associated with positive outcomes, the researchers also found.
Previous research involving lung cancer cells and animal models suggested an association between statins and anticancer properties, according to study background. Other studies also demonstrated a link between statin use and positive outcomes in patients with breast, prostate and colorectal cancer.
Chris R. Cardwell, PhD, of the Centre for Public Health at Queen’s University Belfast in Northern Ireland, and colleagues evaluated data from the National Cancer Data Repository (NCDR). They identified 14,689 patients newly diagnosed lung cancer between 1998 and 2009. NCDR data were linked to the U.K. Clinical Practice Research Datalink to obtain statin prescription records and the Office of National Statistics for mortality data.
Researchers evaluated patient data from 1 year after diagnosis until death, end of registration, last data collection or end of Office of National Statistics follow-up. Data from patients who began using statins after diagnosis and died within 1 year of diagnosis were excluded, although patients who used statins before diagnosis and died within 1 year were not excluded.
Researchers observed data from 3,638 patients who began using statins after diagnosis (11,051 patients excluded, 10,265 of whom died within 1 year of diagnosis) and from 13,398 patients who used statins before diagnosis (1,291 patients excluded for lack of records).
Statin use was associated with older age, male sex, higher BMI, comorbidities and the use of beta-blockers. Statin users after diagnosis were less likely to undergo chemotherapy.
Median follow-up was 3 years among the postdiagnosis cohort and 1 year among the prediagnosis cohort.
Patients who used statins after diagnosis demonstrated an 11% reduction in disease-related mortality (adjusted HR = 0.89; 95% CI, 0.78-1.02) compared with patients who never used statins. Researchers observed a 19% reduction rate in patients prescribed more than 12 statin prescriptions (aHR = 0.81; 95% CI, 0.67-0.98) and a 6% reduction among patients with one to 12 statin prescriptions (aHR = 0.94; 95% CI, 0.81-1.09).
Researchers observed that simvastatin appeared to confer particularly significant benefit (aHR = 0.8; 95% CI, 0.69-0.93). Lipophilic statins conveyed a potentially greater overall benefit (aHR = 0.81; 95% CI, 0.7-0.94) compared with hydrophilic statins (aHR = 1; 95% CI, 0.85-1.18).
Statin use in the year before a lung cancer diagnosis was significantly associated with decreased lung cancer-related mortality (aHR = 0.88; 95% CI, 0.83-0.93). The benefit was similar in patients with one to 12 statin prescriptions or more than 12.
The researchers acknowledged the potential for misclassification of statin use as limitation of their study.
“The magnitude of the association [between statin use and decreased mortality] was relatively small and, as with all observational studies, there is the possibility of confounding — meaning that simvastatin users may have differed from simvastatin nonusers in other ways that could have protected them from death from cancers, for which we could not correct,” Cardwell said in a press release. “However, this finding is worthy of further investigation in observational studies. If replicated in further observational studies, this would provide evidence in favor of conducting a randomized, controlled trial of simvastatin in lung cancer patients.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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