Statin use and prognosis of lung cancer: a systematic review and meta-analysis of observational studies and randomized controlled trials

• Main Authors: Xia DK, Hu ZG, Tian YF, Zeng FJ
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-01-01
• Series: Drug Design, Development and Therapy
• Subjects: statins; lung cancer; prognosis
• Online Access: https://www.dovepress.com/statin-use-and-prognosis-of-lung-cancer-a-systematic-review-and-meta-a-peer-reviewed-article-DDDT

Dao-Kui Xia,1,* Zhi-Gang Hu,2,3,* Yu-Feng Tian,4,* Fan-Jun Zeng2,3 1Department of Thoracic Surgery, Yichang Central People’s Hospital, Yichang, PR China; 2Department of Respiratory Medicine, Respiratory Disease Research Institute of China, Three Gorges University, Yichang, PR China; 3Department of Respiratory Medicine, Yichang Central People’s Hospital, Yichang, PR China; 4Department of Academic Management, Clinical Research Center, Three Gorges University, Yichang, PR China *These authors contributed equally to this work Background: Previous clinical studies reported inconsistent results on the associations of statins with the mortality and survival of lung cancer patients. This review and meta-analysis summarized the impact of statins on mortality and survival of lung cancer patients.Materials and methods: Eligible papers of this meta-analysis were searched by using PubMed, EMBASE, and Cochrane until July 2017. Primary end points were the mortality (all-cause mortality and cancer-specific mortality) and survival (progression-free survival and overall survival) of patients with statin use. Secondary end points were overall response rate and safety. The random-effects model was used to calculate pooled HRs and 95% CIs.Results: Seventeen studies involving 98,445 patients were included in the meta-analysis. In observational studies, the pooled HR indicated that statins potentially decreased the cancer-specific mortality and promoted the overall survival of lung cancer patients. Statins showed an association with decreased all-cause mortality in cohort studies (HR =0.77, 95% CI: 0.59–0.99), but not in case-control studies (HR =0.75, 95% CI: 0.50–1.10). However, statin use showed no impact on mortality and overall survival in randomized controlled trials. Meanwhile, this meta-analysis indicated that statin use did not affect the progression-free survival of lung cancer patients in observational studies and randomized controlled trials. In addition, statins potentially enhanced the effects of tyrosine kinase inhibitors (HR=0.86, 95% CI: 0.76–0.98) and chemotherapy (HR=0.86, 95% CI: 0.81–0.91) on the overall survival of patients with non-small-cell lung cancer, but did not increase overall response rate and toxicity.Conclusion: Statins were potentially associated with the decreasing risk of mortality and the improvement of overall survival in observational studies but not in randomized controlled trials. Keywords: statin, lung cancer, mortality, survival, statins, lung cancer, prognosis