Concomitant Statins can be the Favorable Factor for Gemcitabine and Erlotinib Combination Chemotherapy in Advanced Pancreatic Cancer

Background : Combination chemotherapy of erlotinib with gemcitabine is considered as a standard treatment for unresectable pancreatic cancer. However, which clinical factors are related to the response of this combination is still unknown. This study was aimed to find out the clinical factors for the response of gemcitabine/erlotinib chemotherapy.

Materials and Methods : Between Oct., 2006 and Jan., 2014, a total of 180 patients with unresectable pancreatic cancer, who received at least 2 cycles of gemcitabine/erlotinib combination therapy as a first line palliative chemotherapy, were included. Medical records including medication histories of statins and aspirins were retrospectively collected and analyzed. For this study, we defined “long-term response” which showed tumor stabilization more than 6 cycles of chemotherapy.

Results : Median progression free survival and overall survival were 3.9 months and 8.1 months respectively. In univariate analysis, liver metastasis (p=0.023) had negative correlation with “long-term response”. Locally advanced stage (p=0.017), medication history of statins (p=0.01) and CEA < 4.5 (p=0.029) had favorable effect on “long-term response”. In multivariate analysis, medication history of statins was identified the only independently favorable factor for “long-term response” (OR 4.11, p=0.017). Prognostic factor for OS and PFS showed a significant correlation with liver metastasis(OS : HR 1.46, p=0.038; PFS : HR 1.50, p=0.013)

Conclusion : These results suggest that statins had favorable effect on “long-term response” in gemcitabine/erlotinib chemotherapy for unresectable pancreatic cancer. It would be significant that statins have the chemoadjuvant role to stabilize tumor growth for long term, as almost equal to median survival times.