Drug-drug interactions are a major concern in oncology and may potentially affect the outcome of patients with cancer.
In this study, we aimed to determine whether the concomitant use of statins, metformin, or proton pump inhibitors affects survival in patients with metastatic renal cell carcinoma treated with first-line combination therapies.
Medical records of patients with documented metastatic renal cell carcinoma between January 2016 and November 2021 were reviewed at 17 participating centers. This research was conducted in ten institutions, including both referral centers and local hospitals. Patients were assessed for overall survival, progression-free survival, and overall clinical benefit. Univariate and multivariate analyses were conducted to explore the association of variables of interest with overall survival and progression-free survival.
A total of 304 patients receiving dual immunotherapy (51%) or immunotherapy/vascular endothelial growth factor-tyrosine kinase inhibitor (49%) combinations were eligible for inclusion in this retrospective study. Statin use was a significant prognostic factor for longer overall survival in a univariate analysis (hazard ratio 0.48, 95% confidence interval 0.26-0.87; p = 0.016) and a multivariate analysis (hazard ratio 0.48, 95% confidence interval 0.31-0.74; p < 0.001) and was significantly associated with an overall clinical benefit (83% in statin users vs 71% in non-users; p = 0.045). Otherwise, the use of metformin or proton pump inhibitors did not affect the outcome of these patients.
Our study suggests a prognostic impact of statin use in patients receiving first-line immuno-oncology combinations. The mechanism of this interaction warrants further elucidation.
Targeted oncology. 2022 Aug 10 [Epub ahead of print]
Matteo Santoni, Javier Molina-Cerrillo, Zin W Myint, Francesco Massari, Tomas Buchler, Sebastiano Buti, Marc R Matrana, Ugo De Giorgi, Mimma Rizzo, Ignacio Ortego Zabalza, Luca Galli, Paolo Andrea Zucali, Gaetano Aurilio, Lorena Incorvaia, Maria Bassanelli, Giulia Mammone, Alessia Salfi, Luca Isella, Veronica Mollica, Enrique Grande, Camillo Porta, Nicola Battelli
Oncology Unit, Macerata Hospital, Macerata, Italy., Department of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain., Markey Cancer Center, University of Kentucky, Lexington, KY, USA., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni-15, Bologna, Italy. ., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic., Medical Oncology Unit, University Hospital of Parma, Parma, Italy., Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA, USA., Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy., Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy., Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain., Oncology Unit 2, University Hospital of Pisa, Pisa, Italy., Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy., Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy., Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy., Department of Radiological, Oncological and Anatomo-Pathological Science, "Sapienza" University of Rome, Rome, Italy., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni-15, Bologna, Italy.