Effect of atorvastatin versus placebo on efficacy in patients with diffuse large B-cell lymphoma receiving R-CHOP

Leuk Lymphoma. 2024 Jun;65(6):783-788. doi: 10.1080/10428194.2024.2317343. Epub 2024 Feb 21.

Abstract

STOP-CA was a multicenter, double-blind, randomized, placebo-controlled trial comparing atorvastatin to placebo in treatment-naïve lymphoma patients receiving anthracycline-based chemotherapy. We performed a preplanned subgroup to analyze the impact of atorvastatin on efficacy in patients with diffuse large B-cell lymphoma (DLBCL). Patients received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) at standard doses for six 21-day cycles and were randomly assigned to receive atorvastatin 40 mg daily (n = 55) or placebo (n = 47) for 12 months. The complete response (CR) rate was numerically higher in the atorvastatin arm (95% [52/55] vs. 85% [40/47], p = .18), but this was not statistically significant. Adverse event rates were similar between the atorvastatin and placebo arms. In summary, atorvastatin did not result in a statistically significant improvement in the CR rate or progression-free survival, but both were numerically improved in the atorvastatin arm. These data warrant further investigation into the potential therapeutic role of atorvastatin added to anthracycline-based chemotherapies.

Keywords: Atorvastatin; R-CHOP; anthracycline; diffuse large B-cell lymphoma.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Atorvastatin* / administration & dosage
  • Atorvastatin* / adverse effects
  • Atorvastatin* / therapeutic use
  • Cyclophosphamide* / administration & dosage
  • Cyclophosphamide* / adverse effects
  • Cyclophosphamide* / therapeutic use
  • Double-Blind Method
  • Doxorubicin* / administration & dosage
  • Doxorubicin* / adverse effects
  • Doxorubicin* / therapeutic use
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / mortality
  • Male
  • Middle Aged
  • Prednisone* / administration & dosage
  • Prednisone* / adverse effects
  • Prednisone* / therapeutic use
  • Rituximab* / administration & dosage
  • Rituximab* / adverse effects
  • Rituximab* / therapeutic use
  • Treatment Outcome
  • Vincristine* / adverse effects
  • Vincristine* / therapeutic use

Substances

  • Atorvastatin
  • Prednisone
  • Vincristine
  • Rituximab
  • Doxorubicin
  • Cyclophosphamide
  • R-CHOP protocol