SESSION TYPE: Biomarkers, Oncogenes and Enhanced Bronchoscopy in NSCLC
PRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PM
PURPOSE: Statins have been associated with anti-tumor activity in vitro however few clinical correlations exist. We sought to evaluate whether statin use was associated with lower recurrence rates and improved overall survival (OS) in patients with resectable NSCLC.
METHODS: 803 patients (315 statin and 488 non-statin users) underwent resection for NSCLC between 1998 and 2010. Vital status and recurrence pattern were verified as of 9/2011. Patient demographics, peri-operative clinical and tumor histopathologic characteristics were assessed as predictors of recurrence and/or OS. To reduce potential bias, patients were propensity-score (PS) matched and 208 pairs were generated based on clinically relevant co-morbidities and variables. Recurrence rates and all-cause mortality were summarized using Kaplan-Meier curves. Group comparisons were based on the log-rank test. Covariate adjustments were based on the Cox model with robust covariance matrix.
RESULTS: After PS matching, statin users had significantly higher BMI (kg/m2) values (29 ± 8 vs. 27 ± 7, P=0.021) but otherwise had similar clinical profiles and tumor characteristics. Follow-up was 100% complete with median follow-up of 2.6 years for statin users and 2.7 years for non-statin users. Statin use was associated with a significantly lower local recurrence rate (36%, n=74 vs. 49%, n=102, P=0.02). OS for statin users at 2, 3, and 5 years was 92%, 86%, and 70%, respectively, and was significantly higher than for non-statin users: 83%, 76%, and 54% (log-rank P=0.02). After propensity matching, statin use was still associated with significantly higher OS (hazard ratio = 0.66, 95% CI 0.45-0.96, P=0.03).
CONCLUSIONS: Patients receiving statins had better local control and OS following NSCLC resection as compared to PS-matched patients not on statins. Prospective studies are warranted to assess the role of statin-therapy as an adjunct to current multimodality regimens.
CLINICAL IMPLICATIONS: Statin therapy may be of benefit as an adjunct to improve local control and OS following NSCLC resection. Non-statin users may benefit from more vigilant loco-regional surveillance.
DISCLOSURE: The following authors have nothing to disclose: Satvik Ramakrishna, Adin-Cristian Andrei, John Varlotto, Aubry Colosimo, Julia Shelkey, Vinay Sehgal, Laura Medford-Davis, Shari Meyerson, Alberto de Hoyos, Malcolm DeCamp
No Product/Research Disclosure InformationNorthwestern University Feinberg School of Medicine, Chicago, IL