Research Article: Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study

Date Published: February 3, 2017

Publisher: Public Library of Science

Author(s): Ming-Szu Hung, I-Chuan Chen, Chuan-Pin Lee, Ru-Jiun Huang, Pau-Chung Chen, Ying-Huang Tsai, Yao-Hsu Yang, John Souglakos.


Long-term use of statins has been reported to reduce the risk of death in patients with lung cancer. This study investigated the effect of statin use among patients with lung cancer receiving epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) therapy. A nationwide, population-based case-control study was conducted using the Taiwan National Health Insurance Research Database. From January 1, 1997 to December 31, 2012, a total of 1,707 statin and 6,828 non-statin matched lung cancer cohorts with EGFR-TKIs treatment were studied. Statin use was associated with a reduced risk of death (HR: 0.58, 95% CI: 0.54–0.62, p < 0.001). In addition, statin use was associated with a significantly longer median progression-free survival (8.3 months, 95% CI: 7.6–8.9 vs. 6.1 months, 95% CI: 6.0–6.4, p < 0.001) and median overall survival (35.5 months, 95% CI: 33.8–38.1 vs. 23.9 months, 95% CI: 23.4–24.7, p < 0.001). In conclusion, statins might potentially enhance the therapeutic effect and increase survival in patients with lung cancer receiving EGFR-TKI therapy.

Partial Text

Lung cancer is the most common cause of cancer death worldwide [1]. Most patients have advanced-stage disease at the initial diagnosis of lung cancer. To date, the prognosis of advanced lung cancer remains poor. Despite treatment, the 5-year survival rate for advanced lung cancer remains from 52% to 24% to 4% for local, regional, and distant stage diseases, respectively [2, 3]. Consequently, developing new strategies for lung cancer treatment is necessary.

In this retrospective, nationwide, longitudinal cohort study, statin use was associated with prolonged PFS and OS in patients with lung cancer receiving EGFR-TKI therapy. Further analysis of subpopulations showed that statin use reduced the risk of death in these patients. For the first time, this nationwide population-based study showed the benefit of statin use in patients with lung cancer receiving EGFR-TKI therapy. A novel method of estimating PFS in NHIRD was also developed in our study.




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