Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study

Ming-Szu Hung; I-Chuan Chen; Chuan-Pin Lee; Ru-Jiun Huang; Pau-Chung Chen; Ying-Huang Tsai; Yao-Hsu Yang

doi:10.1371/journal.pone.0171137

Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study

PLoS One. 2017 Feb 3;12(2):e0171137. doi: 10.1371/journal.pone.0171137. eCollection 2017.

Authors

Ming-Szu Hung^{1

2

3}, I-Chuan Chen^{4

5}, Chuan-Pin Lee⁶, Ru-Jiun Huang⁶, Pau-Chung Chen^{7

8}, Ying-Huang Tsai^{1

9}, Yao-Hsu Yang^{6

7

10

11}

Affiliations

¹ Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan.
² Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.
⁴ Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan.
⁵ Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan.
⁶ Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁷ Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
⁸ Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
⁹ Department of Respiratory Care, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
¹⁰ Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan.
¹¹ School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Abstract

Long-term use of statins has been reported to reduce the risk of death in patients with lung cancer. This study investigated the effect of statin use among patients with lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) therapy. A nationwide, population-based case-control study was conducted using the Taiwan National Health Insurance Research Database. From January 1, 1997 to December 31, 2012, a total of 1,707 statin and 6,828 non-statin matched lung cancer cohorts with EGFR-TKIs treatment were studied. Statin use was associated with a reduced risk of death (HR: 0.58, 95% CI: 0.54-0.62, p < 0.001). In addition, statin use was associated with a significantly longer median progression-free survival (8.3 months, 95% CI: 7.6-8.9 vs. 6.1 months, 95% CI: 6.0-6.4, p < 0.001) and median overall survival (35.5 months, 95% CI: 33.8-38.1 vs. 23.9 months, 95% CI: 23.4-24.7, p < 0.001). In conclusion, statins might potentially enhance the therapeutic effect and increase survival in patients with lung cancer receiving EGFR-TKI therapy.

MeSH terms

Adult
Aged
Antineoplastic Agents / therapeutic use*
Carcinoma, Non-Small-Cell Lung / drug therapy
Carcinoma, Non-Small-Cell Lung / metabolism
Carcinoma, Non-Small-Cell Lung / mortality
Case-Control Studies
ErbB Receptors / antagonists & inhibitors*
ErbB Receptors / metabolism*
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Longitudinal Studies
Lung Neoplasms / drug therapy*
Lung Neoplasms / metabolism
Lung Neoplasms / mortality
Middle Aged
Mutation / genetics
Protein Kinase Inhibitors / therapeutic use*
Retrospective Studies

Substances

Antineoplastic Agents
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Protein Kinase Inhibitors
ErbB Receptors

Grants and funding

This study was supported by a grant from Chang Gung Memorial Hospital, Chiayi Branch (CORPG6D0161) (to YHY), Taiwan (R.O.C.).