Abstract 302P
Background
Statins were reported to inhibit tumor growth via suppressing intermediate metabolites of cholesterol synthesis. Concomitant statin use has been reported to associate with better prognosis in some cancer treatment, However, little has been reported on biliary tract cancer (BTC), and also its association with cancer genetic mutations.
Methods
Patients (pts) with unresectable or recurrent BTC diagnosed between Jan 2016 and Mar 2021 were retrospectively enrolled, and divided into two groups: those with statin prescriptions (statin group) and those without (non-statin group), confirmed in medical records during first-line therapy. The primary endpoint was overall survival (OS). The difference of survival benefit among type and strength of statin was also examined. In addition, an exploratory survival analysis was performed on pts with actionable genomic mutations by next genomic sequencing which reported to be associated with statins.
Results
1098 pts were divided into 143 pts of statin group and 952 pts of non-statin group. Statin group included more pts older than 75 and with a BMI ≥19. non-statin group tended to have more pts treated with doublet or triplet regimens. OS of statin group was significantly shorter than that of non-statin group, contrary to our expectation {median (med): 10.5m vs 13.5m, HR 1.33 (95%CI: 1.08–1.63), p=0.0064}, There was no difference in Progression free survival (PFS) between the two groups {med: 6.9m vs 6.4m, HR 0.97 (95%CI: 0.78–1.20), p=0.77}. There was no survival difference in statin group among types and strength. In subgroup analysis of PFS, pts with primary site of distal extrahepatic bile duct {HR 0.46 (95%CI: 0.17–1.25)}, and liver metastases {HR 0.71 (95%CI: 0.50–1.02)} showed favorable outcomes in statin group. In exploratory analysis, 27 pts in statin group and 155 pts of non-statin group had results of NGS. Among pts with TP53 mutations, statin group showed significantly better PFS {med: 26.8m vs 5.8m, HR 0.39 (95%CI: 0.17–0.86), p=0.025}.
Conclusions
In entire population, concomitant statin use didn’t show survival benefit in BTC pts. However, pts with TP53 mutations, primary site of distal extrahepatic bile duct, and liver metastases may benefit from statins.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.