Do Statins Improve Nasopharyngeal Cancer Outcomes?

TOPLINE:

Statin use during concurrent chemoradiotherapy (CCRT) for advanced nasopharyngeal cancer (NPC) is associated with a 52% reduction in all-cause mortality. Higher cumulative defined daily doses of statins correlate with improved survival outcomes, particularly with rosuvastatin and atorvastatin.

METHODOLOGY:

• Statins have demonstrated potential anticancer effects in various malignancies, including the ability to enhance chemotherapy efficacy and reduce radiotherapy toxicity. The integration of statins with standard CCRT regimens for advanced NPC has not been extensively explored in previous research.
• A propensity score–matched cohort study analyzed data from 1251 patients with advanced-stage NPC who underwent standard CCRT between January 2012 and December 2018, with follow-up until December 2020.
• Participants received platinum-based chemotherapy combined with intensity-modulated radiotherapy at doses of 70-70.2 Gy, delivered in fractions of 1.8-2.0 Gy.
• Analysis included 202 statin users who received a minimum of 28 cumulative defined daily doses during CCRT, compared with 1049 non-statin users, with groups matched 1:1 using propensity score matching.
• Researchers assessed overall survival and NPC-specific survival as primary and secondary outcomes, respectively, while analyzing effects of different statin types, cumulative doses, and daily intensities.

TAKEAWAY:

• “Statin use during CCRT demonstrated significant and independent prognostic value for” overall and NPC survival (adjusted hazard ratio [aHR], 0.43; 95% CI, 0.29-0.65; P
• The aHR for all-cause mortality in the statin group compared with the non-statin group was 0.48 (95% CI, 0.34-0.68; P
• Rosuvastatin showed the strongest effect with an aHR of 0.21 (95% CI, 0.19-0.50) for all-cause mortality, while atorvastatin demonstrated an aHR of 0.39 (95% CI, 0.23-0.66).
• Higher cumulative defined daily doses correlated with better survival outcomes, with fourth quartile users showing an aHR of 0.43 (95% CI, 0.24-0.79) for all-cause mortality.
• Daily intensity analysis revealed an aHR of 0.50 (95% CI, 0.33-0.74) for daily defined dose > 1 and an aHR of 0.60 (95% CI, 0.40-0.86) for daily defined dose

IN PRACTICE:

“This study suggests an association between statin use during the CCRT period for NPC and potential enhancements in both [overall survival] and NPC-specific survival. Our findings indicate a possible survival benefit of rosuvastatin, atorvastatin, and lovastatin for patients with NPC undergoing CCRT,” wrote the authors of the study.

SOURCE:

The study was led by Jung-Min Yu, MD, PhD, Taichung Tzu Chi Hospital in Taichung, Taiwan. It was published online in the Journal of the National Comprehensive Cancer Network.

LIMITATIONS:

According to the authors, the study population consisted exclusively of Asian patients, which may limit generalizability to other ethnic groups. The researchers noted that while propensity score matching was used to control for population differences, it may not account for all confounding factors. Additionally, the study’s conservative approach in defining statin users as those with a minimum of 28 cumulative defined daily doses during CCRT may have underestimated the treatment effects.

DISCLOSURES:

The study received funding from Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital (funding numbers: 11303, 11304, and 11404).

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.