SEER Medicare database analysis of statin use with immune checkpoint inhibitors and survival in non-small cell lung cancer in patients aged 65 year or older

Resistance to anti-PD-(L)1 immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (NSCLC) is common, and activation of the YAP-TAZ signaling pathway has been implicated in resistance. Statins are known to be potent YAP inhibitors. Analysis of the SEER-Medicare database found that among elderly (aged ≥ 65 years) patients receiving ICIs for NSCLC, concurrent statin use was associated with 41% lower risk of lung cancer-specific mortality (HR 0.59; 95% CI 0.35-0.99) and overall mortality (0.62; 0.41-0.94) compared with no statin use. Consistent inverse associations were observed when restricting to PD-1 inhibitors and by statin type. The authors conclude that concurrent statin use with ICIs was associated with lower mortality in a population-based sample of older patients with NSCLC. Future work is needed to confirm these findings in prospective studies.