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

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

Author information

1
Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; Immuneering Corporation, Cambridge, MA 02142, USA.
2
Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA.
3
Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
4
Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA; Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address: Chao.Cheng@dartmouth.edu.

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

PMID:
30527197
PMCID:
PMC6296763
[Available on 2019-12-01]
DOI:
10.1016/j.lungcan.2018.10.022

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