International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Cancer Sci. 2020 Aug;111(8):2965-2973. doi: 10.1111/cas.14493. Epub 2020 Jul 6.
Statins have been shown to be a beneficial treatment as chemotherapy and target therapy for lung cancer. This study aimed to investigate the effectiveness of statins in combination with epidermal growth factor receptor-tyrosine kinase inhibitor therapy for the resistance and mortality of lung cancer patients. A population-based cohort study was conducted using the Taiwan Cancer Registry database. From January 1, 2007, to December 31, 2012, in total 792 non-statins and 41 statins users who had undergone EGFR-TKIs treatment were included in this study. All patients were monitored until the event of death or when changed to another therapy. Kaplan-Meier estimators and Cox proportional hazards regression models were used to calculate overall survival. We found that the mortality was significantly lower in patients in the statins group compared with patients in the non-statins group (4-y cumulative mortality, 77.3%; 95% confidence interval (CI), 36.6%-81.4% vs. 85.5%; 95% CI, 78.5%-98%; P = .004). Statin use was associated with a reduced risk of death in patients the group who had tumor sizes <3 cm (hazard ratio [HR], 0.51, 95% CI, 0.29-0.89) and for patients in the group who had CCI scores <3 (HR, 0.6; 95% CI, 0.41-0.88; P = .009). In our study, statins were found to be associated with prolonged survival time in patients with lung cancer who were treated with EGFR-TKIs and played a synergistic anticancer role.
他汀类药物已被证明对肺癌的化疗和靶向治疗有益。本研究旨在探讨他汀类药物联合表皮生长因子受体酪氨酸激酶抑制剂治疗对肺癌患者耐药性和死亡率的影响。本研究采用基于人群的台湾癌症登记数据库进行。2007 年 1 月 1 日至 2012 年 12 月 31 日期间,共纳入 792 名未使用他汀类药物和 41 名使用他汀类药物的患者,这些患者均接受了表皮生长因子受体酪氨酸激酶抑制剂治疗。所有患者均接受监测,直至死亡或改用其他治疗。采用 Kaplan-Meier 估计器和 Cox 比例风险回归模型计算总生存期。结果发现,他汀类药物组患者的死亡率明显低于未使用他汀类药物组(4 年累积死亡率,77.3%;95%置信区间(CI),36.6%-81.4%比 85.5%;95%CI,78.5%-98%;P=0.004)。在肿瘤直径<3cm(风险比[HR],0.51;95%CI,0.29-0.89)和Charlson 合并症指数(CCI)评分<3(HR,0.6;95%CI,0.41-0.88;P=0.009)的患者中,他汀类药物的使用与死亡风险降低相关。在本研究中,我们发现他汀类药物与接受表皮生长因子受体酪氨酸激酶抑制剂治疗的肺癌患者的生存时间延长相关,并发挥了协同抗癌作用。