Gastrointestinal Cancer

PD 05 - GI 2 - Poster Discussion

1036 - Targeting Tumor Metabolism With Statins during Treatment for Locoregionally Advanced Pancreatic Cancer

Monday, October 22
10:45 AM - 10:51 AM
Location: Room 217 A/B

Targeting Tumor Metabolism With Statins during Treatment for Locoregionally Advanced Pancreatic Cancer
N. A. Iarrobino1, B. S. Gill2, M. E. Bernard3, and C. E. Champ4; 1University of Pittsburgh School of Medicine, Pittsburgh, PA, 2UPMC Hillman Cancer Center, Pittsburgh, PA, 3Department of Radiation Medicine, University of Kentucky, Lexington, KY, 4Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA

Purpose/Objective(s): A growing body of preclinical data suggests that statins may exert potent anti-tumor effects, yet the interactions of these medications with standard therapies, like radiation therapy, and clinical outcomes in this population is less clear. We assessed the impact of statin use on outcomes in patients with advanced-stage pancreatic adenocarcinoma undergoing various treatments.

Materials/Methods: After IRB approval, we conducted a retrospective-cohort study consisting of 303 newly diagnosed advanced-stage pancreatic adenocarcinoma patients to determine the impact of statin use on outcomes. All patients received stereotactic body radiation therapy as single or three-fractions regimens as either monotherapy or in combination with surgery and systemic therapy. Univariate and multivariable Cox proportional hazard regression models were utilized to estimate hazard ratios. Time-to-event was estimated using Kaplan-Meier survival analysis for overall survival, distant metastasis, and locoregional failure. Baseline and active statin usage were assessed and to mitigate risk of immortal time bias, sub-analysis excluding patients with under 6 months of follow-up was conducted.

Results: Both prior (p=0.021) and active (p=0.030) statin usage correlated with improved survival in this cohort. Surgery, chemoradiation, and statin use improved 2-year survival rates (84.1 vs. 55.0%, p<0.001). On multivariable analysis, statin exposure was associated with overall survival (HR 0.662, p=0.027) and trended to significance for freedom from distant metastasis (HR 0.577, p=0.060). Comorbid conditions were not significantly associated with outcomes.

Conclusion: Statin use was associated with improved overall survival in advanced-stage pancreatic adenocarcinoma patients. This data supports previous findings in early-stage pancreatic adenocarcinoma and other cancer sites. To our knowledge this is the first report to examine the efficacy of statin use as a supplementary treatment option in advanced-stage pancreatic adenocarcinoma patients.

Author Disclosure: N.A. Iarrobino: None. B.S. Gill: None. M.E. Bernard: None. C.E. Champ: None.

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