Nick A Iarrobino1, Beant Gill, Mark E Bernard, Mark V Mishra, Colin E Champ. 1. *University of Pittsburgh School of Medicine †Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA ‡Department of Radiation Medicine, University of Kentucky, Lexington, KY §Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD.
Abstract
INTRODUCTION: A growing body of preclinical data suggests that statins may exert potent antitumor effects, yet the interactions of these medications with standard therapies and clinical outcomes in this population is less clear. We assessed the impact of statin use on outcomes in patients with advanced-stage pancreatic adenocarcinoma undergoing various treatments. MATERIALS AND METHODS: After institutional review board approval, we conducted a retrospective-cohort study consisting of 303 newly diagnosed advanced-stage pancreatic adenocarcinoma patients to determine the impact of statin use on outcomes. Univariate and multivariable Cox proportional hazard regression models were utilized to estimate hazard ratios (HRs). Time-to-event was estimated using Kaplan-Meier survival analysis for overall survival, distant metastasis, and locoregional failure. Baseline and active statin usage were assessed and to mitigate risk of immortal time bias, subanalysis excluding patients with under 6 months of follow-up was conducted. RESULTS: Both prior (P=0.021) and active (P=0.030) statin usage correlated with improved survival in this cohort. Surgery, chemoradiation, and statin use improved 2-year survival rates (84.1% vs. 55.0%; P<0.001). On multivariable analysis, statin exposure was associated with overall survival (HR, 0.662; P=0.027) and trended to significance for freedom from distant metastasis (HR, 0.577; P=0.060). Comorbid conditions were not significantly associated with outcomes. CONCLUSIONS: Statin use was associated with improved overall survival in advanced-stage pancreatic adenocarcinoma patients. This data supports previous findings in early-stage pancreatic adenocarcinoma and other cancer sites. To our knowledge this is the first report to examine the efficacy of statin use as a supplementary treatment option in advanced-stage pancreatic adenocarcinoma patients.
INTRODUCTION: A growing body of preclinical data suggests that statins may exert potent antitumor effects, yet the interactions of these medications with standard therapies and clinical outcomes in this population is less clear. We assessed the impact of statin use on outcomes in patients with advanced-stage pancreatic adenocarcinoma undergoing various treatments. MATERIALS AND METHODS: After institutional review board approval, we conducted a retrospective-cohort study consisting of 303 newly diagnosed advanced-stage pancreatic adenocarcinomapatients to determine the impact of statin use on outcomes. Univariate and multivariable Cox proportional hazard regression models were utilized to estimate hazard ratios (HRs). Time-to-event was estimated using Kaplan-Meier survival analysis for overall survival, distant metastasis, and locoregional failure. Baseline and active statin usage were assessed and to mitigate risk of immortal time bias, subanalysis excluding patients with under 6 months of follow-up was conducted. RESULTS: Both prior (P=0.021) and active (P=0.030) statin usage correlated with improved survival in this cohort. Surgery, chemoradiation, and statin use improved 2-year survival rates (84.1% vs. 55.0%; P<0.001). On multivariable analysis, statin exposure was associated with overall survival (HR, 0.662; P=0.027) and trended to significance for freedom from distant metastasis (HR, 0.577; P=0.060). Comorbid conditions were not significantly associated with outcomes. CONCLUSIONS: Statin use was associated with improved overall survival in advanced-stage pancreatic adenocarcinomapatients. This data supports previous findings in early-stage pancreatic adenocarcinoma and other cancer sites. To our knowledge this is the first report to examine the efficacy of statin use as a supplementary treatment option in advanced-stage pancreatic adenocarcinomapatients.
Authors: Jessica Chubak; Denise M Boudreau; Heidi S Wirtz; Barbara McKnight; Noel S Weiss Journal: J Natl Cancer Inst Date: 2013-08-12 Impact factor: 13.506
Authors: Nicholas G Zaorsky; Mark K Buyyounouski; Tianyu Li; Eric M Horwitz Journal: Int J Radiat Oncol Biol Phys Date: 2012-05-30 Impact factor: 7.038
Authors: Matthew H G Katz; Peter W T Pisters; Douglas B Evans; Charlotte C Sun; Jeffrey E Lee; Jason B Fleming; J Nicolas Vauthey; Eddie K Abdalla; Christopher H Crane; Robert A Wolff; Gauri R Varadhachary; Rosa F Hwang Journal: J Am Coll Surg Date: 2008-03-17 Impact factor: 6.113
Authors: Kimberly D Miller; Rebecca L Siegel; Chun Chieh Lin; Angela B Mariotto; Joan L Kramer; Julia H Rowland; Kevin D Stein; Rick Alteri; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2016-06-02 Impact factor: 508.702
Authors: Lara Lacerda; Jay P Reddy; Diane Liu; Richard Larson; Li Li; Hiroko Masuda; Takae Brewer; Bisrat G Debeb; Wei Xu; Gabriel N Hortobágyi; Thomas A Buchholz; Naoto T Ueno; Wendy A Woodward Journal: Stem Cells Transl Med Date: 2014-05-15 Impact factor: 6.940
Authors: Nick A Iarrobino; Beant S Gill; Mark Bernard; Rainer J Klement; Maria Werner-Wasik; Colin E Champ Journal: Front Oncol Date: 2018-07-27 Impact factor: 6.244