Patients with rectal cancer experienced improved pathologic response to neoadjuvant chemoradiotherapy when using statins in a study presented at the American Society of Colon and Rectal Surgeons Annual Meeting in Phoenix.
Researchers evaluated 407 patients with rectal cancer who underwent preoperative neoadjuvant chemoradiotherapy between 2000 and 2012 at a single medical institution, including 99 patients also on statin therapy upon treatment initiation. Pathological response to chemoradiotherapy was assessed according to ypT stage and AJCC grades, with an AJCC grade of 0 indicating complete response, 1 indicating the presence of individual or small groups of tumor cells, 2 “residual cancer outgrown by fibrosis” and 3 “extensive residual cancer.”
“In my basic science laboratory, we studied different gene profiles that were associated with worse response to chemoradiation therapy,” researcher Matthew Kalady, MD, assistant professor of surgery and colorectal surgeon at the Cleveland Clinic, told Healio.com. “One of the pathways that we uncovered was involved with lipid metabolism, suggesting that too much lipid might be associated with worse outcomes. Also, there has been some recent data in other cancer types that statin therapy improves outcome for patients being treated with chemotherapy. Therefore, we decided to review our experience of rectal cancer patients that were on a lipid-lowering drug during chemoradiation treatment.”
Statin users were older and had a significantly higher BMI than nonusers (P<.001 for both). Response to therapy, defined as an AJCC grade of 0-2, occurred more frequently among users (88.9% vs. 80.2%, P=.049), as did stronger response, defined as an AJCC grade of 0 or 1 (65.7% vs. 48.7%, P=.004). Patients using statins also were more likely to have a ypT stage of 0 (19.2% vs. 11.2%), while stages 1-3 were more frequent among nonusers (5.8% vs. 5.1% for 1, 26.4% vs. 21.2% for 2 and 47.5% vs. 37.4% for stage 3) (P=.015).
Tumor size (P=.15), distance from anal verge (P=.52) and cancer stage (P=.81) did not differ significantly according to statin use.
“Statin use during neoadjuvant chemoradiation in rectal cancer is associated with improved pathological response in this retrospective study,” the researchers concluded. “This data encourages design of [a] prospective investigation combining statins and neoadjuvant chemoradiation as a way of potentially improving patient response.”
For more information:
Mace AG. S73: Statin Therapy Is Associated With Improved Pathologic Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer. Presented at: The American Society of Colon and Rectal Surgeons Annual Meeting 2013; April 27–May 1, Phoenix.