Yonsei Med J.  2016 Sep;57(5):1124-1130. 10.3349/ymj.2016.57.5.1124.

Concomitant Statin Use Has a Favorable Effect on Gemcitabine-Erlotinib Combination Chemotherapy for Advanced Pancreatic Cancer

• Moon DC
• Lee HS
• Lee YI
• Chung MJ
• Park JY
• Park SW
• Song SY
• Chung JB
• Bang S

• KMID: 2374156
• DOI: http://doi.org/10.3349/ymj.2016.57.5.1124

Abstract

PURPOSE
Erlotinib-gemcitabine combined chemotherapy is considered as the standard treatment for unresectable pancreatic cancer. This study aimed to determine the clinical factors associated with response to this treatment.
MATERIALS AND METHODS
This retrospective study included 180 patients with unresectable pancreatic cancer who received ≥2 cycles of gemcitabine-erlotinib combination therapy as first-line palliative chemotherapy between 2006 and 2014. "Long-term response" was defined as tumor stabilization after >6 chemotherapy cycles.
RESULTS
The median progression-free survival (PFS) and overall survival (OS) were 3.9 and 8.1 months, respectively. On univariate analysis, liver metastasis (p=0.023) was negatively correlated with long-term response. Locally advanced stage (p=0.017), a history of statin treatment (p=0.01), and carcinoembryonic antigen levels <4.5 (p=0.029) had a favorable effect on long-term response. On multivariate analysis, a history of statin treatment was the only independent favorable factor for long-term response (p=0.017). Prognostic factors for OS and PFS were significantly correlated with liver metastasis (p=0.031 and 0.013, respectively). A history of statin treatment was also significantly associated with OS after adjusting for all potential confounders (hazard ratio, 0.48; 95% confidence interval, 0.26-0.92; p=0.026).
CONCLUSION
These results suggest that statins have a favorable effect on "long-term response" to gemcitabine-erlotinib chemotherapy in unresectable pancreatic cancer patients. Statins may have a chemoadjuvant role in stabilizing long-term tumor growth.

Keyword

Hydroxymethylglutaryl-CoA reductase inhibitors; pancreatic neoplasms; erlotinib; gemcitabine

MeSH Terms

Adenocarcinoma/*drug therapy/secondary
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Deoxycytidine/administration & dosage/analogs & derivatives
Disease-Free Survival
Erlotinib Hydrochloride/administration & dosage
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
Male
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms/*drug therapy/pathology
Retrospective Studies
Survival Rate
Young Adult
Deoxycytidine
Erlotinib Hydrochloride
Hydroxymethylglutaryl-CoA Reductase Inhibitors

Figure

• 

  Fig. 1 A history of statin treatment was revealed to be the only favorable factor associated with "long-term response" on multivariate analysis and with OS. Kaplan-Meier curves for overall survival in pancreatic cancer patients with statin and without statin (log-rank p=0.059). OS, overall survival.

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