Patients Benefit From Statin-Ibrutinib Combo

TOPLINE:

Statin use in chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) patients showed significant survival benefits, with a 45% lower risk for overall mortality and 27% reduced risk for disease progression. Benefits remain consistent across treatment types, with no increase in severe adverse effects.

METHODOLOGY:

• Individual participant data were pooled from four randomized trials: RESONATE, RESONATE-2, iLLUMINATE, and HELIOS, with a total of 1467 participants.
• Analysis included Cox proportional hazards models for overall survival (OS), progression-free survival (PFS), and cancer-specific survival, along with logistic regression models for grade ≥ 3 adverse effects.
• Researchers adjusted for multiple variables including age, sex, weight, ECOG performance status, disease diagnosis, bulky disease (≥ 5 cm), time since initial diagnosis, comorbidity count, and cardiovascular medication use.
• Patient distribution showed 1350 (92%) diagnosed with CLL, whereas 117 (8%) had SLL, with 424 (29%) participants using statins at baseline.
• Median follow-up duration reached 60.5 months for OS and 22 months for PFS across the pooled cohort.

TAKEAWAY:

• Statin use showed significant association with improved OS (adjusted hazard ratio [AHR], 0.55; 95% CI, 0.42-0.72; P < .001), PFS (AHR, 0.73; 95% CI, 0.61-0.88; P = .001), and cancer-specific survival (AHR, 0.39; 95% CI, 0.22-0.70; P = .001).
• Results remained consistent across ibrutinib versus non-ibrutinib treatment arms (OS P-interaction = .52, PFS P-interaction = .31) and CLL vs SLL diagnosis (OS P-interaction = .77, PFS P-interaction = .32).
• No significant association emerged between statin use and grade ≥ 3 adverse effects in both univariable (odds ratio [OR], 0.93; 95% CI, 0.69-1.24) and adjusted analysis (OR, 0.92; 95% CI, 0.65-1.28).
• The 2-year OS probability reached 89% (95% CI, 86-92) for statin users compared with 82% (95% CI, 79-84) for nonusers.

IN PRACTICE:

“This study provides valuable insights into the associations of baseline statin use with survival and adverse event outcomes in patients with CLL/SLL initiating contemporary treatment regimens. The findings revealed a statistically significant association between statin utilization and improved OS, PFS and cancer-specific survival. The latter suggests a potential disease-modifying effect of statins in this patient population. No significant associations were observed between statin use and the occurrence of grade > 3 adverse events. Notably, statin use emerged as a consistent positive prognostic factor irrespective of the specific treatment type or diagnosis, suggesting a consistent association between statin use and enhanced clinical outcomes,” wrote the authors of the study.

SOURCE:

The study was led by Ahmad Y. Abuhelwa, Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah in Sharjah, United Arab Emirates. It was published online in Blood Advances.

LIMITATIONS:

The findings’ generalizability to real-world populations is limited by clinical trial eligibility criteria. Statin use may correlate with unmeasured factors linked to improved survival, such as socioeconomic status or healthcare access. Data limitations included the absence of IGHV and TP53 mutation status, patient crossover data to Bruton tyrosine kinase (BTK) inhibitor regimens, and insufficient event counts within individual statin subgroups. According to the authors, while this study examined BTK inhibitor–containing regimens with statin use, ibrutinib is now less widely used given the availability of acalabrutinib and zanubrutinib, and none of the control arm regimens are in widespread clinical use anymore.

DISCLOSURES:

The study was supported by a grant from the University of Sharjah. Ashley M. Hopkins disclosed support from the National Health and Medical Research Council, Australia. Humaid O. Al-Shamsi reported ties with Roche, Merck Sharp & Dohme, Bristol Myers Squibb, AstraZeneca, and Novartis. All other authors had no disclosures. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.