Statins have benefits in multiple myeloma

By Megan Brooks

New findings point to a potential role for statin drugs in patients with multiple myeloma.

In a large cohort of US veterans with newly diagnosed MM, treatment with a statin was associated with a 21% reduced risk of death from any cause and a 24% reduced risk of death from MM.

"Prior to our publication, there was a growing wealth of research looking at the impact of statin therapy on health outcomes in patients with cancer. However, there was limited data on the effect statins have in patients with multiple myeloma," first author Dr. Kristen Marie Sanfilippo from Washington University School of Medicine in St. Louis, noted in email to Reuters Health.

A prior study of 16 patients found a decrease in treatment resistance with the addition of simvastatin to MM-directed therapy, she and her colleagues note in their Journal of Clinical Oncology September 19 online report. A retrospective analysis of 146 patients with MM undergoing autologous stem cell transplantation found a trend toward increased overall response rates in patients taking a statin, but no change in progression-free or overall survival. And a trial of 91 patients receiving thalidomide and dexamethasone with or without lovastatin found improved progression-free survival with lovastatin and a trend toward improved overall survival.

To investigate in a larger cohort, the researchers used the Veterans Administration Central Cancer Registry to identify 4,957 patients newly diagnosed with MM between 1999 and 2013. Of these, 2,294 received statin therapy, which they defined as having any prescription for a statin within 90 days before or any time after MM diagnosis.

With statin use, the adjusted hazard ratio for death from any cause was 0.79 (95% CI, 0.73 to 0.86; P<0.001). For MM-specific mortality, the adjusted HR with statin therapy was 0.76 (95% CI, 0.67 to 0.86; P<0.001).

This association remained significant across all sensitivity analyses. Statin use was also associated with a decreased risk of skeletal-related events, even after adjusting for use of a bisphosphonate, the investigators say.

Dr. Sanfilippo told Reuters Health, "There is biologic plausibility to support a potential role given the mechanism of statins on the mevalonate pathway, a mechanism shared by bisphosphonates, (which have) been shown to improve survival in myeloma."

In vivo and in vitro studies have found that MM cell death and cell growth arrest are accelerated with statin therapy. Also, statins decrease angiogenesis and reduce the metastatic potential of tumor cells. Statins have also been shown to stimulate bone formation.

"Our study further supports the need and role for a randomized clinical trial assessing the therapeutic role of statins in multiple myeloma," Dr. Sanfilippo said.

The study had no commercial funding.

SOURCE: http://bit.ly/2cXJHCz

J Clin Oncol 2016.

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