The study, believed to be the first of its kind, suggests the statins do not interfere with the effects of frontline therapies.
Statins improved overall, progression-free and cancer-specific survival in a cohort of leukaemia patients.
The development of BTK-targeted therapies such as ibrutinib has been a boon for the management of chronic lymphocytic leukaemia and small lymphocytic leukaemia. Yet little is known how other common medications these cancer patients may also be taking may impact the effectiveness of these novel therapies.
Now, a recent study designed to investigate the association between statin use and survival in a cohort of CLL and SLL patients suggests statins lower the likelihood of death by 38%.
“Our study demonstrated that statin use was a consistent positive prognostic factor for both SLL and CLL, underscoring the potential advantages of statins in these patient populations. These results are not surprising given that CLL and SLL are now considered biologically the same disease,” the researchers wrote in Blood Advances.
Researchers combined individual patient data from almost 1500 patients across four clinical trials where patients with CLL or SLL were administered 420mg ibrutinib each day. Roughly one in three patients were also using statins at baseline.
The median follow-up time for overall survival across the pooled cohort was five years.
After adjusting for factors such as cancer diagnosis, age, sex, comorbidities and the use of other cardiovascular drugs, statin users were 38% less likely to die from any cause and 26% less likely to experience disease progression compared to non-users. Patients using statins were also 61% less likely to die from CLL or SLL.
Comparted to patients not taking statins at baseline, patients using statins prior to participating in their respective trial had higher two-year overall (89% versus 82%) and progression-free (54% versus 46%) survival.
There was no difference between overall or progression-free survival between ibrutinib and non-ibrutinib users or patients diagnosed with CLL compared to those diagnosed with SLL.
“This suggests a generally consistent association of statin use with improved survival outcomes across different treatment types and study cohorts,” the researchers noted.
Furthermore, there was no association between statin use and grade three or higher adverse effects (i.e., medically significant but not life-threatening events) in the adjusted analyses.
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The researchers proposed a number of potential explanations for the results, pointing to the anti-inflammatory and anti-cancer effects of statins.
“The sensitivity of CLL/SLL cells to statins may be due to the role of cholesterol in the pathogenesis of these malignancies, as CLL cells rely on lipid metabolism for proliferation,” they wrote.
“Furthermore, HMG-CoA reductase levels, targeted by statins, are elevated up to 20-fold in haematological malignancies, including CLL cells, suggesting a potential mechanism for their cytotoxic effects.
“Statins may [also] improve outcomes by reducing LDL levels and intracellular cholesterol, leading to fewer circulating CLL cells and longer lymphocyte doubling times.”
