No Evident Prognostic Benefit of Statin Use in Diffuse Large B-Cell Lymphoma Patients with Unfavorable Disease Features Treated with R-DA-EPOCH.

in Pharmacology by Anica Sabljic, Martina Sedinic Lacko, Rajko Kusec, Vlatko Pejsa, Marko Lucijanic

TLDR

  • A recent study found no significant association between statin use and clinical outcomes in diffuse large B-cell lymphoma patients treated with R-DA-EPOCH immunochemotherapy.
  • The study suggests that statins may not have a clinically significant impact on treatment outcomes, but further research is needed to confirm these findings.

Abstract

Recent reports indicate that patients with aggressive non-Hodgkin lymphomas might benefit if concomitantly receiving statins with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine (Oncovin) and prednisone immunochemotherapy. We retrospectively analyzed a cohort of 130 newly diagnosed diffuse large B-cell lymphomas with unfavorable clinical features treated with first-line rituximab, dose-adjusted etoposide, prednisone, vincristine [Oncovin], cyclophosphamide, hydroxydaunorubicin (R-DA-EPOCH) immunochemotherapy in period 2005-2019. A total of 17/130 (13.1%) patients received statins concomitantly with immunochemotherapy, mostly atorvastatin and in intermediate statin dose intensity. Besides tendency to be associated with older age (p = 0.070), there were no other significant associations of statins use with neither sex, disease stage, R-IPI, or other unfavorable disease features (p > 0.05 for all analyses). Also, no significant differences were present considering feasibility (number of cycles with dose escalation/reduction), toxicity (number of cycles with anemia, thrombocytopenia, neutropenia, febrile neutropenia, and septic complications) nor efficacy (response rates) of R-DA-EPOCH regimen (p > 0.05 for all analyses). Also, statin use had no significant association with neither OS (p = 0.480) nor PFS (p = 0.891). Lack of associations of statin use with relevant clinical outcomes was further corroborated by multivariate analyses.

Overview

  • The study investigated the potential benefits of concomitantly administering statins with immunochemotherapy for diffuse large B-cell lymphomas with unfavorable clinical features.
  • The study analyzed a cohort of 130 patients treated with R-DA-EPOCH immunochemotherapy between 2005-2019 and compared the outcomes of patients who received statins concomitantly with immunochemotherapy.
  • The primary objective was to assess the impact of statins on the feasibility, toxicity, efficacy, OS, and PFS of R-DA-EPOCH regimen.

Comparative Analysis & Findings

  • There was no significant association between statin use and disease stage, R-IPI, or other unfavorable disease features.
  • No significant differences were found in the feasibility, toxicity, or efficacy of R-DA-EPOCH regimen between patients who received statins and those who did not.
  • Multivariate analyses also failed to show any significant associations between statin use and OS or PFS.

Implications and Future Directions

  • The study suggests that statins may not have a clinically significant impact on the outcomes of diffuse large B-cell lymphoma patients treated with R-DA-EPOCH immunochemotherapy.
  • Future studies may consider investigating other potential benefits of statins, such as their role in preventing cardiovascular events in lymphoma patients.
  • The study highlights the importance of carefully evaluating the benefits and risks of concomitant medication use in cancer treatment.
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