To assess the association between statin use and survival outcomes in lung cancer patients treated with immune checkpoint inhibitors (ICIs).
Approach:
Search Strategy: Systematic search of PubMed, Embase, the Cochrane Library, and Web of Science for studies published until June 2026 evaluating statin use in lung cancer patients receiving ICIs.
Data Extraction: Two investigators independently screened literature, extracted data, and evaluated risk of bias using the Newcastle-Ottawa Scale (NOS).
Endpoints: Overall survival (OS) and progression-free survival (PFS) were the primary endpoints analyzed.
Statistical Analysis: Meta-analysis conducted using Stata 15.0 software.
Key Findings:
Statin use was associated with significantly better overall survival (OS) (HR = 0.76, 95% CI (0.63, 0.91), P = 0.003) and progression-free survival (PFS) (HR = 0.82, 95% CI (0.69, 0.96), P = 0.017).
Survival advantage for OS and PFS remained significant in multivariate-adjusted estimates.
Statins significantly improved OS in non-Asian populations, but PFS benefit was not statistically significant.
Limitations:
Most included studies were retrospective observational designs, necessitating cautious interpretation of results.
Statistical significance for endpoints was not achieved in univariate analyses or among larger studies (n > 500).
Conclusion:
Further prospective, large-scale randomized controlled trials are needed to verify survival benefits from combined statin and ICI therapy and establish optimal timing and target populations.
