Statin use improves the efficacy of nivolumab in patients with advanced renal cell carcinoma.

Statins are widely used in an ageing population, including subjects with solid malignancies. However, no conclusive evidence is currently available on their potential influence on patients' outcome. We aimed to assess whether statin exposure affects the survival of patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab.

Medical records of patients with documented mRCC treated with second- or third-line nivolumab were reviewed at ten institutions from Italy, Spain and the USA. Patients were assessed for overall survival (OS), progression-free survival (PFS), and overall clinical benefit. Univariate and multivariate analyses were used to explore the association of variables of interest with survival.

A total of 219 patients with mRCC receiving nivolumab between January 2016 and September 2021 were eligible for inclusion in this study; 59 (27%) were statin users. The median OS (34.4 versus 18.6 months, p = 0.017) and PFS (11.7 versus 4.6 months, p = 0.013) resulted apparently longer in statin users. Stratified by age, longer median OS and PFS were associated with statin exposure in both patients aged ≥70 y (median OS: 21.4 versus 10.1 months, p = 0.047; median PFS: 16.4 versus 4.6 months, p = 0.022) and <70 y (median OS: 34.4 versus 21.4 months, p = 0.043; median PFS: 10.3 versus 4.6 months, p = 0.042). Overall clinical benefit resulted higher in statin users than non-users (71% versus 54%, p = 0.030).

Our study suggests a prognostic impact of statin use in patients receiving nivolumab for mRCC.

European journal of cancer (Oxford, England : 1990). 2022 Jun 30 [Epub ahead of print]

Matteo Santoni, Francesco Massari, Marc R Matrana, Umberto Basso, Ugo De Giorgi, Gaetano Aurilio, Sebastiano Buti, Lorena Incorvaia, Mimma Rizzo, Angelo Martignetti, Diana Maslov, Karine Tawagi, Ernest Philon, Zoe Blake, Camillo Porta, Nicola Battelli

Oncology Unit, Macerata Hospital, Via Santa Lucia 2, 62100, Macerata, Italy. Electronic address: ., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy., Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA, USA., Oncology 3 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy., Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy., Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy., Medical Oncology Unit, University Hospital of Parma, Parma, Italy; Department of Medicine and Surgery, University of Parma, Parma, Italy., Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy., Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Piazza G. Cesare 11, 70124 Bari, Italy., Dipartimento oncologico usl sud-est toscana-area senese, Località Campostaggia s.n.c., 53036 Poggibonsi, Italy., Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Piazza G. Cesare 11, 70124 Bari, Italy; Chair of Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy., Oncology Unit, Macerata Hospital, Via Santa Lucia 2, 62100, Macerata, Italy.