Survival impact of concomitant use of PCSK9 inhibitors versus statins among patients receiving immune checkpoint inhibitors for cancer

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition enhances antitumor efficacy of immune checkpoint inhibitors (ICIs) in preclinical models, but clinical evidence is limited. A comparative effectiveness study using deidentified data from the TriNetX research network investigated survival and selected clinical outcomes among adults receiving ICIs for non-small cell lung cancer, melanoma, or renal cell carcinoma concomitantly using PCSK9 inhibitors versus high-intensity statin therapy. A total of 239 propensity score matched pairs were identified from 243 patients in the PCSK9 inhibitor cohort and 13,293 patients in the statin-only cohort. Primary outcomes were overall survival and a modified 4-point major adverse cardiovascular event (MACE) composite. PCSK9 inhibitor use was associated with improved all-cause mortality and reduced levels of acute health care uitlization, without significant differences in MACEs. The authors conclude that these findings warrant prospective evaluation of PCSK9 inhibition as a potential adjunct to immune checkpoint inhibitors.