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Concomitant Statin Use Has a Favorable Effect on Gemcitabine-Erlotinib Combination Chemotherapy for Advanced Pancreatic Cancer

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초록

Purpose: Erlotinib-gemcitabine combined chemotherapy is considered as the standard treatment for unresectable pancreaticcancer. This study aimed to determine the clinical factors associated with response to this treatment. Materials and Methods: This retrospective study included 180 patients with unresectable pancreatic cancer who received ≥2 cyclesof gemcitabine-erlotinib combination therapy as first-line palliative chemotherapy between 2006 and 2014. “Long-term response”was defined as tumor stabilization after >6 chemotherapy cycles. Results: The median progression-free survival (PFS) and overall survival (OS) were 3.9 and 8.1 months, respectively. On univariateanalysis, liver metastasis (p=0.023) was negatively correlated with long-term response. Locally advanced stage (p=0.017), a history ofstatin treatment (p=0.01), and carcinoembryonic antigen levels <4.5 (p=0.029) had a favorable effect on long-term response. Onmultivariate analysis, a history of statin treatment was the only independent favorable factor for long-term response (p=0.017). Prognosticfactors for OS and PFS were significantly correlated with liver metastasis (p=0.031 and 0.013, respectively). A history of statintreatment was also significantly associated with OS after adjusting for all potential confounders (hazard ratio, 0.48; 95% confidenceinterval, 0.26–0.92; p=0.026). Conclusion: These results suggest that statins have a favorable effect on “long-term response” to gemcitabine-erlotinib chemotherapyin unresectable pancreatic cancer patients. Statins may have a chemoadjuvant role in stabilizing long-term tumor growth.

Abstract

Purpose: Erlotinib-gemcitabine combined chemotherapy is considered as the standard treatment for unresectable pancreaticcancer. This study aimed to determine the clinical factors associated with response to this treatment. Materials and Methods: This retrospective study included 180 patients with unresectable pancreatic cancer who received ≥2 cyclesof gemcitabine-erlotinib combination therapy as first-line palliative chemotherapy between 2006 and 2014. “Long-term response”was defined as tumor stabilization after >6 chemotherapy cycles. Results: The median progression-free survival (PFS) and overall survival (OS) were 3.9 and 8.1 months, respectively. On univariateanalysis, liver metastasis (p=0.023) was negatively correlated with long-term response. Locally advanced stage (p=0.017), a history ofstatin treatment (p=0.01), and carcinoembryonic antigen levels <4.5 (p=0.029) had a favorable effect on long-term response. Onmultivariate analysis, a history of statin treatment was the only independent favorable factor for long-term response (p=0.017). Prognosticfactors for OS and PFS were significantly correlated with liver metastasis (p=0.031 and 0.013, respectively). A history of statintreatment was also significantly associated with OS after adjusting for all potential confounders (hazard ratio, 0.48; 95% confidenceinterval, 0.26–0.92; p=0.026). Conclusion: These results suggest that statins have a favorable effect on “long-term response” to gemcitabine-erlotinib chemotherapyin unresectable pancreatic cancer patients. Statins may have a chemoadjuvant role in stabilizing long-term tumor growth.

참고문헌 (36)

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