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. 2016 Sep:99:137-42.
doi: 10.1016/j.lungcan.2016.07.006. Epub 2016 Jul 6.

The effect of statins on survival in patients with stage IV lung cancer

Jenny J Lin  1 , Nicole Ezer  2 , Keith Sigel  2 , Grace Mhango  2 , Juan P Wisnivesky  3
Affiliations

The effect of statins on survival in patients with stage IV lung cancer

Jenny J Lin et al. Lung Cancer. 2016 Sep.

Abstract

Objectives: Prior studies have shown an anticancer effect of statins in patients with certain malignancies. However, it is unclear whether statins have a mortality benefit in lung cancer. We compared survival of patients with stage IV non-small cell lung cancer (NSCLC) receiving vs. not receiving statins prior to diagnosis.

Methods: Using data from the Surveillance, Epidemiology and End Results registry linked to Medicare claims, we identified 5118 patients >65 years of age diagnosed with stage IV NSCLC between 2007 and 2009. We used propensity score methods to assess the association of statin use with overall and lung cancer-specific survival while controlling for measured confounders.

Results: Overall, 27% of patients were on statins at time of lung cancer diagnosis. Median survival in the statin group was 7 months, compared to 4 months in patients not treated with statins (p<0.001). Propensity score analyses found that statin use was associated with improvement in overall (hazard ratio [HR]: 0.76, 95% confidence interval [CI]: 0.73-0.79) and lung cancer-specific survival (HR: 0.77, 95% CI: 0.73-0.81), after controlling for baseline patient characteristics, cancer characteristics, staging work-up and chemotherapy use.

Conclusions: Statin use is associated with improved survival among patients with stage IV NSCLC suggesting a potential anticancer effect. Further research should evaluate plausible biological mechanisms as well as test the effect of statins in prospective clinical trials.

Keywords: Non-small cell lung cancer; Outcomes; Statins; Survival analysis.

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Conflict of interest statement

All other authors are without any conflicts of interest.

Figures

Figure 1
Figure 1. Kaplan-Meier Overall Survival Curves for all patients in cohort
Patients in the statin group have better overall survival compared to those in the non-statin group.
Figure 2
Figure 2. Stratified Kaplan-Meier Overall Survival Curves
Stratified by (A) patients who received systemic chemotherapy, (B) patients who received oral chemotherapy (C) patients who did not receive systemic or oral chemotherapy, (D) patients who received PET scan, (E) patients who did not receive PET scan
Figure 2
Figure 2. Stratified Kaplan-Meier Overall Survival Curves
Stratified by (A) patients who received systemic chemotherapy, (B) patients who received oral chemotherapy (C) patients who did not receive systemic or oral chemotherapy, (D) patients who received PET scan, (E) patients who did not receive PET scan
Figure 2
Figure 2. Stratified Kaplan-Meier Overall Survival Curves
Stratified by (A) patients who received systemic chemotherapy, (B) patients who received oral chemotherapy (C) patients who did not receive systemic or oral chemotherapy, (D) patients who received PET scan, (E) patients who did not receive PET scan
Figure 2
Figure 2. Stratified Kaplan-Meier Overall Survival Curves
Stratified by (A) patients who received systemic chemotherapy, (B) patients who received oral chemotherapy (C) patients who did not receive systemic or oral chemotherapy, (D) patients who received PET scan, (E) patients who did not receive PET scan
Figure 2
Figure 2. Stratified Kaplan-Meier Overall Survival Curves
Stratified by (A) patients who received systemic chemotherapy, (B) patients who received oral chemotherapy (C) patients who did not receive systemic or oral chemotherapy, (D) patients who received PET scan, (E) patients who did not receive PET scan
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