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Statins augment efficacy of EGFR-TKIs in patients with advanced-stage non-small cell lung cancer harbouring KRAS

Ondrej Fiala1, Milos Pesek, Jindrich Finek

  • 1Department of Oncology and Radiotherapy, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, alej Svobody 80, 304 60, Pilsen, Czech Republic, fiala.o@centrum.cz.

Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine
|February 23, 2015
PubMed

Insights

Adding statins to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) significantly improved progression-free survival in patients with KRAS-mutated non-small cell lung cancer (NSCLC). Overall survival showed a non-significant trend towards improvement with the combination therapy.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are effective for advanced non-small cell lung cancer (NSCLC).
  • KRAS mutations are associated with poor prognosis in NSCLC patients treated with EGFR-TKIs.
  • Statins have demonstrated potential in inhibiting tumor cell growth and metastasis.

Purpose of the Study:

  • To evaluate the efficacy of combining statins with EGFR-TKIs in patients with KRAS-mutated NSCLC.
  • To compare progression-free survival (PFS) and overall survival (OS) between patients treated with EGFR-TKI alone versus EGFR-TKI plus statin.

Main Methods:

  • Retrospective analysis of clinical data from 67 patients with stage IIIB/IV NSCLC and KRAS mutations.
  • Patients received either EGFR-TKI (erlotinib or gefitinib) alone (55 patients) or in combination with statin (12 patients).
  • Progression-free survival (PFS) and overall survival (OS) were compared using the Gehan-Wilcoxon test.

Main Results:

  • The median PFS was 1.0 month for EGFR-TKI alone versus 2.0 months for the combination therapy (p=0.025).
  • The median OS was 5.4 months for EGFR-TKI alone versus 14.0 months for the combination therapy (p=0.130).
  • A statistically significant improvement in PFS was observed with the addition of statins.

Conclusions:

  • Combination therapy of statins and EGFR-TKIs shows a significant improvement in PFS for patients with KRAS-mutated NSCLC.
  • While not statistically significant, a trend towards improved OS was noted with the combination therapy.
  • Statins may represent a beneficial addition to EGFR-TKI treatment in this patient population.

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