Do statins, ACE inhibitors or sartans improve outcome in primary glioblastoma?

Area of Science:

• Neuro-oncology
• Clinical pharmacology
• Cancer treatment

Background:

• Glioblastomas are aggressive brain tumors with limited treatment options.
• Emerging data suggested potential anti-tumor effects of statins, ACE inhibitors (ACEI), and sartans in various cancers.
• Drug repurposing is an attractive strategy for improving glioblastoma outcomes.

Purpose of the Study:

• To evaluate the association of co-treatment with statins, ACEI, or sartans with patient outcomes in newly diagnosed glioblastoma.
• To analyze the impact of these common medications on progression-free survival (PFS) and overall survival (OS).
• To assess if these drugs could be repurposed for glioblastoma treatment.

Main Methods:

• Secondary analysis of 810 patients from the phase III CENTRIC and phase II CORE trials.
• Patients received cilengitide for newly diagnosed glioblastoma, with or without MGMT promoter methylation.
• Progression-free survival (PFS) and overall survival (OS) were compared between patients using statins, ACEI, or sartans versus controls.

Main Results:

• No significant association was found between statins, ACEI, or sartans and improved PFS or OS in the pooled glioblastoma cohort.
• Median OS for statins was 22.1 vs. 22.2 months (HR 1.06, p=0.69); for ACEI was 20.4 vs. 22.6 months (HR 1.25, p=0.10); for sartans was 21.7 vs. 22.3 months (HR 0.86, p=0.38).
• Analyses controlled for MGMT promoter methylation and treatment groups did not reveal any survival benefit.

Conclusions:

• Co-treatment with statins, ACE inhibitors, or sartans did not demonstrate a significant association with improved outcomes in patients with newly diagnosed glioblastoma.
• These findings challenge the current rationale for prospective studies investigating these non-tumor-specific drugs for glioblastoma drug repurposing.
• Further research is needed to explore novel therapeutic strategies for glioblastoma.