You’ve looked at the hypothesis that statins might be of influence or of interest in renal cell carcinoma. Could you tell me about the analysis that you’ve recently done?
Certainly. So we conducted a retrospective review of a pooled clinical trials database exploring the benefit of statins in patients with RCC. There have been preclinical studies to suggest the anti-proliferative effects of statins and in other cancers, such as prostate, breast, colorectal cancer, statins have been shown to actually improve cancer specific survival.
You said you did a pooled analysis but what sort of patients were you looking at and how did you get to the statin data?
The patients that we were looking at were patients who were enrolled on phase II and phase III clinical trials. We had over 4,500 patients in the study and patients were either receiving first line or second line standard therapy for kidney cancer. So that was our patient population.
How much did the statin use vary between different members of that group?
10% of the patients in the group, about 511 patients, actually were statin users.
So you had a sample of 400 or so patients who were statin users, did they stand out from the rest?
They did. So in regards to their survival patients who were statin users had improved survival compared to patients who were not statin users.
By how much?
By six months, which was statistically significant.
Yes. So what do you think doctors should read into these data?
This is a retrospective review that’s very hypothesis generating as to whether statins actually influence outcomes in RCC. I think there are a couple of steps in moving forward, one is trying to understand mechanistically why this is, so trying to analyse this in the preclinical setting. The second step is looking at the benefit of statins in a prospective fashion, in a clinical trial basically.
What do you think the mechanisms might be?
It’s hard to postulate. In vivo data suggests that actually statins can inhibit proliferation, they can induce apoptosis, they can effect DNA damage. So it’s postulated that through these mechanisms, and possibly some synergy with the VEGF targeted therapy and mTOR targeted therapy, they could be employing their benefit.
Do you think that benefit might be confined to renal cell carcinoma or could it be more widely applied in oncology?
Possibly more widely applied. The reason we’re looking at it in renal cell carcinoma is because of the fact that it has previously been shown to be potentially impacting survival for patients with colorectal cancer, breast cancer, prostate cancer, some of the major cancers that are out there. So it’s never really been looked at in RCC so we looked at it in RCC because of the data that’s already been out in the field.
So what’s the brief take home message, then, coming out of your study?
The brief take home message is for patients who have an indication to be a statin user, such as dyslipidemia or cardiovascular disease, use of statins in patients with metastatic RCC may actually impact their survival.
