Patients with Lung Cancer Do Not Benefit from Statins

Clinical trial results suggest reconsideration of current and planned trials in the use of statins in lung cancer therapy.
Clinical trial results suggest reconsideration of current and planned trials in the use of statins in lung cancer therapy.

According to a phase 3 trial, statins used in conjunction with chemotherapy had no effect on treatment outcomes in patients with lung cancer. These results contradict recent research indicating that statins can play a role in preventing the development of cancer or prolong survival in patients with some types of common cancers, including lung cancer.1

These results suggest reconsideration of current and planned trials in the use of statins in cancer therapy.

Statins lower cholesterol levels and are frequently prescribed to protect against heart attacks and strokes. Several small recent studies examined the potential of statins to limit proliferation and survival of cancerous cells.

In LUNGSTAR, a multicenter, phase 3 trial of the statin pravastatin added to first-line standard chemotherapy in patients with small cell lung cancer, researchers randomly assigned 846 patients from 91 hospitals to receive pravastatin or placebo in conjunction with chemotherapy. Patients were monitored over 2 years.

Although administration of pravastatin did not result in adverse effects, it did not result in any advantages.

"It's becoming increasingly common for patients with increased cholesterol to take statins, and many cancer patients will be or have been prescribed these drugs entirely separately from their cancer treatment," explained Michael Seckl, PhD, MD, professor at Imperial College, London, United Kingdom, and an investigator with the study.

"There's no reason for people to stop taking statins to manage their cholesterol, but it's extremely unlikely, for patients with small cell lung cancer, that taking statins will make any difference to their cancer treatment outcome. Because all statins work in a similar way to lower cholesterol, it's relatively unlikely that statins other than pravastatin would have a different, more beneficial effect."

The researchers will continue to examine the mechanisms of action of statins, but believe further large-scale trials are unwarranted.

"Our results match those of other randomized trials examining different types of cancer, but these were much smaller than our own study, and they have also shown no benefit to using statins in cancer treatment," explained Allan Hackshaw, PhD, deputy director of the Cancer Research UK & UCL Cancer Trials Center, London, United Kingdom, and an investigator with the study.

"Collectively, this evidence seems quite persuasive."

The 2-year overall survival (OS) was 13.2% for pravastatin (95% CI, 10.0 to 16.7) vs 14.1% (95% CI, 10.9 to 17.7) for placebo, with a hazard ratio of 1.01 (95% CI, 0.88 to 1.16; P =.90).

The median OS was 10.6 months in the pravastatin arm vs 10.7 months in the placebo arm. Median progression-free survival was 7.7 months in the pravastatin arm vs 7.3 months in the placebo arm.

"It is possible that ongoing statin trials of other types of cancers might find a benefit, and so it would be interesting to see their findings when available,” said Dr Hackshaw.

“However, I think researchers should consider carefully whether to start a new statin trial as part of cancer treatment, without results from further large studies like ours."

Reference

1. Seckl MJ, Ottensmeier CH, Cullen M, et al. Multicenter, phase III, randomized, double-blind, placebo-controlled trial of pravastatin added to first-line standard chemotherapy in small-cell lung cancer (LUNGSTAR) . J Clin Oncol. 2017 Feb 27. doi: 10.1200/JCO.2016.69.7391 [Epub ahead of print]

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