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Statins Linked to Improved Survival in CLL and SLL Patients
A recent study published in the journal Blood Advances has revealed that patients diagnosed with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who were on statin medications at the onset of their cancer treatment experienced a 61% lower risk of cancer-related mortality compared to those who did not take statins.
“This is the initial systematic exploration of how statin use correlates with survival outcomes in patients diagnosed with CLL or SLL, specifically in those being treated with modern targeted therapeutics such as ibrutinib,” stated Ahmad Abuhelwa, PhD, a lead researcher and assistant professor in pharmacy practice and pharmacotherapeutics at the University of Sharjah in the UAE. “Our findings underscore a significant connection between statin intake and enhanced survival in this demographic.”
CLL, the most prevalent form of leukemia among adults in the United States, is characterized by a gradual increase in cancerous cells originating from the blood-forming marrow. SLL, while also a slow-progressing cancer, primarily begins in lymphoid tissues like the spleen but affects the same cell types as CLL.
Statins, popular medications prescribed to lower cholesterol levels, are taken by more than 90 million adults in the U.S. to mitigate risks of heart disease, which can precipitate serious conditions like heart attacks and strokes. Prior research has suggested a correlation between statin use and decreased mortality rates across various cancers, including CLL. However, these earlier investigations did not assess outcomes in conjunction with newer cancer therapies, such as the targeted treatment ibrutinib, noted Dr. Abuhelwa.
In this study, Dr. Abuhelwa and his team evaluated data from 1,467 individuals diagnosed with CLL or SLL, sourced from four international clinical trials conducted between 2012 and 2019. Participants were randomly assigned to receive either ibrutinib—sometimes combined with other anticancer drugs—or an alternative treatment regimen. Notably, 424 of these patients, or 29%, were taking statins upon initiating their treatment. The study cohort had a median age of 65, with 66% of participants being male; 92% had CLL, whether newly diagnosed or previously treated without success.
The primary outcomes measured were cancer-specific survival (the duration patients lived after treatment initiation before dying from cancer), overall survival (total lifespan post-treatment regardless of death cause), and progression-free survival (time until cancer worsened or patients died). Additionally, the researchers assessed the rate of severe or life-threatening side effects. The median follow-up duration was five years for overall survival and 22 months for progression-free survival.
To mitigate the impact of confounding variables, the research team adjusted their findings for several factors, including patient diagnosis, age, sex, BMI, physical health assessments, disease intensity, time since diagnosis, presence of other illnesses, concurrent heart medications, and the specific anticancer therapies administered.
The analysis revealed that statin users experienced an impressive 61% reduced risk of cancer mortality, a 38% decreased risk of death from any cause, and a 26% lowered risk of cancer progression, independent of the confounding factors considered. Crucially, the use of statins did not lead to an increase in severe or life-threatening adverse events.
“While these results are compelling, they do not definitively establish that statins improve cancer outcomes directly,” Dr. Abuhelwa explained. “The robustness of this association, even after adjusting for numerous influencing factors, indicates that it deserves further investigation.” He advocates for laboratory studies aimed at elucidating how statins might interact with cancer biology and recommends prospective clinical trials to randomly assign CLL or SLL patients to statin therapy or a control group.
The observational nature of the study presents certain limitations. Patients involved in clinical trials are often subject to more rigorous monitoring than those treated outside these settings, which could affect the generalizability of the findings. Additionally, since patients used various types of statins at differing doses, the research could not pinpoint specific impacts associated with particular statin classes, dosages, or treatment durations.
“Although our findings are encouraging, we cannot endorse the initiation of statin use solely on the basis of this study for treating CLL or SLL,” Dr. Abuhelwa concluded. “Further clinical trials are essential to provide conclusive evidence regarding the direct implications of statin therapy on cancer survival rates.”
This research received funding from the University of Sharjah Targeted Research Grant.
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