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International Journal of Colorectal Disease

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01-12-2021 | Rectal Cancer | Original Article

Concurrent use of statins and neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis

Authors: Tyler McKechnie, Gaurav Talwar, Yung Lee, Oren Levine, Cagla Eskicioglu

Published in: International Journal of Colorectal Disease | Issue 12/2021

Abstract

Purpose

Statins are used primarily in patients with cardiovascular disease. More recently, they have demonstrated benefit in oncology patients. In vitro models have shown decreased rectal tumor cell viability in cells receiving chemoradiation and statin therapy. In vivo models have been less clear. This study aims to elucidate the impact of concurrent use of statins on the efficacy of neoadjuvant therapy for rectal cancer.

Methods

Search of Medline, EMBASE, and CENTRAL was performed. Articles were included if they reported complete pathological response (pCR), long-term oncologic outcomes, or chemoradiotherapy-induced toxicity in patients with rectal cancer receiving concurrent statin and neoadjuvant therapy. A pairwise meta-analyses was performed using inverse variance random effects.

Results

From 1564 citations, six studies with 726 patients on statin therapy (24.5% female, age: 63.6 years) and 1863 patients not on statin therapy (35.6% female, age: 60.9 years) were included. There was no significant difference in pCR rate between patients on statin therapy and patients not on statin therapy (RR 1.23, 95%CI 0.98–1.54, p = 0.08). Similarly, no difference existed between groups in long-term oncologic outcomes (5-year overall survival: RR 1.03, 95%CI 0.86–1.24, p = 0.75; 5-year disease-free survival: RR 1.04, 95%CI 0.85–1.26, p = 0.73). Chemoradiotherapy-induced toxicities were similar between groups.

Conclusion

The concurrent use of statin and neoadjuvant therapy did not significantly impact short- or long-term oncologic outcomes in patients with rectal cancer. Yet, despite pooling of data, this study remained inadequately powered. Larger, prospective studies are required to further elucidate the impact of statins on patients undergoing neoadjuvant therapy for rectal cancer.

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Title: Concurrent use of statins and neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis
Authors: Tyler McKechnie
Gaurav Talwar
Yung Lee
Oren Levine
Cagla Eskicioglu
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Statins
Published in: International Journal of Colorectal Disease / Issue 12/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-04016-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Concurrent use of statins and neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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