Statins associate with improved mortality among patients with certain histological subtypes of lung cancer

Lung Cancer. 2018 Dec;126:89-96. doi: 10.1016/j.lungcan.2018.10.022. Epub 2018 Oct 25.

Abstract

Objectives: To measure the association between statin exposure and mortality in lung cancer patients belonging to different categories of histological subtype.

Materials and methods: A cohort of 19,974 individuals with incident lung cancer between 2007 and 2011 was identified using the SEER-Medicare linked database. Statin exposure both pre- and post-diagnosis was analyzed to identify a possible association with cancer-specific mortality in patients stratified by histological subtype. Intention-to-treat analyses and time-dependent Cox regression models were used to calculate hazard ratios and 95% confidence intervals (95% CIs) corresponding to statin exposure both pre- and post-diagnosis, respectively.

Results: Overall baseline statin exposure was associated with a decrease in mortality risk for squamous-cell carcinoma patients (HR = 0.89, 95% CI = 0.82-0.96) and adenocarcinoma patients (HR = 0.87, 95% CI = 0.82-0.94), but not among those with small-cell lung cancer. Post-diagnostic statin exposure was associated with prolonged survival in squamous-cell carcinoma patients (HR = 0.68, 95% CI = 0.59-0.79) and adenocarcinoma patients (HR = 0.78, 95% CI = 0.68-0.89) in a dose-dependent manner.

Conclusion: There is consistent evidence indicating that baseline or post-diagnostic exposure to simvastatin and atorvastatin is associated with extended survival in non-small-cell lung cancer subtypes. These results warrant further randomized clinical trials to evaluate subtype-specific effects of certain statins in patient cohorts with characteristics similar to those examined in this study.

Keywords: Adenocarcinoma; Histological subtypes; Lung cancer; Retrospective cohort study; SEER-medicare; Small-cell lung cancer; Squamous-cell carcinoma; Statins; Survival analysis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / mortality
  • Aged
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Male
  • Proportional Hazards Models
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Small Cell Lung Carcinoma / diagnosis
  • Small Cell Lung Carcinoma / drug therapy*
  • Small Cell Lung Carcinoma / mortality
  • Survival Rate
  • United States

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors