Zhou Qiang, Jiao Zhihua, Liu Yuxi, Devreotes Peter N, Zhang Zhenyu
Department of Administration, Shenzhen Center for Prehospital Care, Shenzhen, China.
Department of Cell Biology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
Front Oncol. 2023 Aug 18;13:1234713. doi: 10.3389/fonc.2023.1234713. eCollection 2023.
Statin therapy has been shown to reduce mortality in a wide range of cancer types and overall stages. Still, there is uncertainty about its efficacy in increasing survival among advanced cancer patients.
We conducted a meta-analysis with data from all studies that compared the hazard ratio of overall survival, cancer-specific survival, and progression-free survival in patients with advanced-stage cancer who receive statin therapy. Studies were selected from the PubMed, Embase, and Web of Science databases from their inception to December 31, 2022. Cancer types are limited to those rarely screened during the annual examination and more likely to develop into advanced stages, such as lung, pancreatic and ovarian cancers. This resulted in 27 studies eligible for meta-analysis.
Statin therapy was associated with a 26% decreased risk of overall survival (HR, 0.74; 95% CI, 0.67, 0.81), 26% decreased risk of cancer-specific survival (HR, 0.74; 95% CI, 0.61-0.88), and 24% decreased risk of progression-free survival (HR, 0.76; 95% CI, 0.65-0.87) for advanced-stage cancer patients. The associations were not attenuated or reinforced by study design, study regions, cancer types, or other medical care. Concomitant use of other anticancer medications did not result in confounding effects.
Statin therapy produces significant benefits on overall survival and cancer-specific survival. Although the benefits might be lower than the approved immunotherapy medications, its cost-effectiveness could lead to dramatic health consequences. Concomitant use of statin drugs as cancer treatments is highly recommended in future clinical trials.
他汀类药物治疗已被证明可降低多种癌症类型和各期癌症患者的死亡率。然而,其在提高晚期癌症患者生存率方面的疗效仍存在不确定性。
我们对所有比较接受他汀类药物治疗的晚期癌症患者总生存期、癌症特异性生存期和无进展生存期风险比的研究数据进行了荟萃分析。研究从PubMed、Embase和Web of Science数据库建库至2022年12月31日进行选取。癌症类型限于年度检查中很少筛查且更易发展为晚期的癌症,如肺癌、胰腺癌和卵巢癌。这使得27项研究符合荟萃分析的条件。
对于晚期癌症患者,他汀类药物治疗与总生存期风险降低26%(风险比,0.74;95%置信区间,0.67, 0.81)、癌症特异性生存期风险降低26%(风险比,0.74;95%置信区间,0.61 - 0.88)和无进展生存期风险降低24%(风险比,0.76;95%置信区间,0.65 - 0.87)相关。这些关联并未因研究设计、研究地区、癌症类型或其他医疗护理而减弱或增强。同时使用其他抗癌药物未产生混杂效应。
他汀类药物治疗对总生存期和癌症特异性生存期产生显著益处。尽管这些益处可能低于已获批的免疫治疗药物,但其成本效益可能会带来巨大的健康影响。强烈建议在未来的临床试验中将他汀类药物作为癌症治疗药物联合使用。