Evidence map›Paper›PMID 30657380›Full record

ArticleJCO clinical cancer informatics2017

Epidemiologic Analysis Along the Mevalonate Pathway Reveals Improved Cancer Survival in Patients Who Receive Statins Alone and in Combination With Bisphosphonates.

Sherif M El-Refai, Joshua D Brown, Susanne M Arnold, Esther P Black, Markos Leggas, Jeffery C Talbert

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JCO clinical cancer informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. The Mevalonate Pathway in the Radiation Response of Cancer.International journal of radiation oncology, biology, physics · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sherif M El-RefaiSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.
Joshua D BrownSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.
Susanne M ArnoldSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.
Esther P BlackSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.
Markos LeggasSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.
Jeffery C TalbertSherif M. El-Refai, Susan M. Arnold, Esther P. Black, Markos Leggas, and Jeffery C. Talbert, University of Kentucky, Lexington, KY; and Joshua D. Brown, University of Florida, Gainesville, FL.

Funding

Kentucky Center for Clinical and Translational ScienceUL1TR000117 · NCATS · UNIVERSITY OF KENTUCKY · PI KERN, PHILIP A · 2012 to 2015
$13.3M
NCATS NIH HHS UL1 TR000117
6 · The paper itself

Abstract

purposeCohort studies report associations between statin use and improved survival in patients with cancer. We used pharmacoepidemiologic methods to evaluate the survival of patients with cancer who received statins alone or in ostensibly synergistic drug combinations. MATERIALS AND

methodsPatients with cancer who were diagnosed from 2010 to 2013 were identified in a large health care claims database. The rate of all-cause death up to 1 year after diagnosis was compared by Cox proportional hazard regression. Sensitivity analyses included age stratification, statin type and intensity, and comparison with or without bisphosphonates and dipyridamole.

resultsAmong 312,907 identified patients with cancer, treatment groups included statin users (n = 65,440), nonstatin users who received medications that block cholesterol absorption (n = 9,289), and nonusers (n = 226,007). Statin use before diagnosis was associated with improved overall survival compared with no treatment (hazard ratio [HR], 0.85; 95% CI, 0.80 to 0.91) and specifically in patients with leukemia, lung, or renal cancers. Nonstatin users had increased overall survival compared with no treatment (HR, 0.73; 95% CI, 0.62 to 0.85); when stratified, this difference held true only for pancreatic cancer and leukemia. No differences were observed between statin and nonstatin groups. Bisphosphonate use alone had no effect (n = 4,528), but patients who used both statins and bisphosphonates (n = 4,090) had increased survival compared with no treatment (HR, 0.60; 95% CI, 0.45 to 0.81). The effect of the combination of dipyridamole and statin use (n = 651) was not significant compared with no treatment.

conclusionThis study suggests that the combination of statins with drugs that affect isoprenylation, such as bisphosphonates, improves survival in patients with cancer. Consideration of pathway-specific pharmacology allows for hypotheses testing with the pharmacoepidemiologic approach. Prospective evaluation of these findings warrants clinical investigation and preclinical mechanistic studies.

Indexed as

AgedAged, 80 and overComorbidityDatabases, FactualDiphosphonatesDisease ManagementDrug Therapy, CombinationFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedNeoplasmsPrognosisTreatment OutcomeUnited StatesDiphosphonatesHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID30657380
PMCPMC6467073
OpenAlexW2625797373

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.