Re: 'High-intensity statins are associated with improved clinical activity of PD-1 inhibitors in malignant pleural mesothelioma and advanced non-small cell lung cancer patients'

Our plain-English summary of Re: 'High-intensity statins are associated with improved clinical activity of PD-1 inhibitors in malignant pleural mesothelioma and advanced non-small cell lung cancer patients', by A. Hara, M. Matsuda, A. Ishii, et al (European Journal of Cancer, 2021).

The study

• Authors: A. Hara, M. Matsuda, A. Ishii, T. Yoshioka
• Journal: European Journal of Cancer
• Published: 2021;153:265-266
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a research study, and it reported no new data. Four authors from Japan commented on an earlier article by Cantini and colleagues. That article examined whether use of statins (cholesterol-lowering drugs) was associated with outcomes in patients with malignant pleural mesothelioma or advanced non-small cell lung cancer who were treated with PD-1 inhibitors, a type of immunotherapy. The letter did not discuss asbestos. The authors raised three concerns. First, the earlier study combined both cancers in one group, although the authors described them as fundamentally different. Second, it did not describe in detail how statin use was measured from medical records. Third, the authors questioned how it handled confounding factors. They argued that histological (tissue) subtype did not need adjusting for, that factors such as nutritional status and vascular conditions were left out, and that lung cancer subtypes were classified in an unusual way. The authors concluded that the link between statin use and outcomes in these patients was still inconclusive, and they called for more robust observational studies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on another published study (Cantini et al.); no new data
• Who was studied: No patients were studied in this letter. It discusses the Cantini et al. study of patients with malignant pleural mesothelioma (MPM) and advanced non-small cell lung cancer (aNSCLC) treated with PD-1 inhibitors.
• Exposure: Statin use, the exposure in the critiqued study. Asbestos exposure was not discussed.
• Main results:
  • The authors objected that the critiqued study combined MPM and aNSCLC in one study population, although in their view the two cancers are fundamentally different.
  • The authors stated that the critiqued study did not describe in detail how statin use was measured from electronic medical records.
  • The authors argued that histological subtype was not a true confounding factor because it is unrelated to statin use.
  • The authors argued that nutritional status and comorbidities representing vascular risks should have been adjusted for as residual confounding factors.
  • The authors stated that the critiqued study classified aNSCLC as adenocarcinoma versus non-adenocarcinoma rather than squamous versus non-squamous as in ESMO guidelines.
• The authors' conclusion: The authors concluded that the association between statin use and clinical outcomes of patients treated with PD-1 inhibitors is still inconclusive, and that robust observational studies overcoming these limitations are warranted.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Non-Small Cell Lung Cancer.

Related studies

• High-intensity statins are associated with improved clinical activity of PD-1 inhibitors in malignant pleural mesothelioma and advanced non-small cell lung cancer patients — L. Cantini, F. Pecci, et al. (2021)
• Re: Comments on 'High-intensity statins are associated with improved clinical activity of programmed cell death protein 1 inhibitors in malignant pleural mesothelioma and advanced non-small cell lung cancer patients' — L. Cantini, F. Pecci, et al. (2021)
• Statins do not alter the incidence of mesothelioma in asbestos exposed mice or humans — C. Robinson, H. Alfonso, et al. (2014)
• Promoter methylation of DAP-kinase: association with advanced stage in non-small cell lung cancer — D.H. Kim, H.H. Nelson, et al. (2001)
• Simple nutritional intervention in patients with advanced cancers of the gastrointestinal tract, non-small cell lung cancers or mesothelioma and weight loss receiving chemotherapy: a randomised controlled trial — C. Baldwin, A. Spiro, et al. (2011)
• A randomised study comparing the effectiveness of acupuncture or morphine versus the combination for the relief of dyspnoea in patients with advanced non-small cell lung cancer and mesothelioma — A. Minchom, R. Punwani, et al. (2016)

Browse more research in European Journal of Cancer, or return to medical research.