Statins and clinical outcomes in patients with advanced hepatocellular carcinoma treated with Atezolizumab plus Bevacizumab

The impact of statins on patients receiving immune checkpoint inhibitors for advanced hepatocellular carcinoma (aHCC) remains unclear. This study aimed to evaluate whether statins influence overall survival (OS) and progression-free survival (PFS) in aHCC patients receiving Atezolizumab + Bevacizumab (A + B). ARTE is a prospectively maintained dataset of 305 aHCC patients treated with A + B. Among these, 63 patients receiving statins were identified and propensity score-matched to 63 non-statin users. Primary outcomes were OS and PFS, while treatment discontinuation due to liver-related events was assessed as a secondary outcome. The median treatment duration was 6.4 months (IQR 2.7-13.2). Among the 126 matched patients, viral etiology was the most common (44.4%), followed by metabolic dysfunction-associated steatotic liver disease (MASLD) (40.5%). Median OS was 23 months [95% CI 17.2-28.7] in statin users vs. 16 months [95% CI 12.8-19.2] in non-users, while median PFS was 12 months [95% CI 4.1-19.9] in statin users vs. 8 months [95% CI 4.0-12.0] in non-users, with no significant differences between groups. In multivariate Cox regression, MASLD-induced HCC was associated with a higher risk of progression or death (HR 1.68, 95% CI 1.03-2.75). Statins did not reduce the risk of treatment discontinuation due to liver-related events (HR 1.05, 95% CI 0.27-4.14). Statins did not improve OS or PFS, nor did they reduce the risk of treatment discontinuation due to liver-related events in aHCC patients receiving A + B. Notably, MASLD-related HCC exhibited worse PFS, suggesting a potential differential response to systemic therapies, which warrants further investigation.

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Journal
Scientific Reports
Published
2025-11-23
DOI
https://doi.org/10.1038/s41598-025-25752-4
Citations
1
Primary Topic
Cancer, Lipids, and Metabolism
Type
article
Field-Weighted Citation Impact
0.94

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article

Statins and clinical outcomes in patients with advanced hepatocellular carcinoma treated with Atezolizumab plus Bevacizumab

Francesco Giuseppe Foschi, Leonardo Stella, Tiziana Pressiani, Filippo Cattazzo et al.
1 citations
Scientific Reports
Cancer, Lipids, and Metabolism
0.94
article

Statins and clinical outcomes in patients with advanced hepatocellular carcinoma treated with Atezolizumab plus Bevacizumab

Francesco Giuseppe Foschi, Leonardo Stella, Tiziana Pressiani, Filippo Cattazzo, Stefania De Lorenzo, Francesco Tovoli, Gianluca Svegliati‐Baroni, Ciro Celsa, Giuseppe Cabibbo, Piera Federico, Benedetta Stefanini, Caterina Vivaldi, Andrea Palloni, L.A. Natola, Claudia Campani, Mariangela Bruccoleri, Marco Vicardi, Gianluca Masi, Bruno Daniele, Francesca Romana Ponziani, Caterina Soldà, Giovanni Brandi, Ingrid Garajová, Fabio Marra, Maria Antonietta Ricci, David Sacerdoti, Massimo Alberto Iavarone, Andrea Dalbeni, E. Franceschini, Lorenza Rimassa, A. Auriemma
article en
1 citations

Abstract

The impact of statins on patients receiving immune checkpoint inhibitors for advanced hepatocellular carcinoma (aHCC) remains unclear. This study aimed to evaluate whether statins influence overall survival (OS) and progression-free survival (PFS) in aHCC patients receiving Atezolizumab + Bevacizumab (A + B). ARTE is a prospectively maintained dataset of 305 aHCC patients treated with A + B. Among these, 63 patients receiving statins were identified and propensity score-matched to 63 non-statin users. Primary outcomes were OS and PFS, while treatment discontinuation due to liver-related events was assessed as a secondary outcome. The median treatment duration was 6.4 months (IQR 2.7-13.2). Among the 126 matched patients, viral etiology was the most common (44.4%), followed by metabolic dysfunction-associated steatotic liver disease (MASLD) (40.5%). Median OS was 23 months [95% CI 17.2-28.7] in statin users vs. 16 months [95% CI 12.8-19.2] in non-users, while median PFS was 12 months [95% CI 4.1-19.9] in statin users vs. 8 months [95% CI 4.0-12.0] in non-users, with no significant differences between groups. In multivariate Cox regression, MASLD-induced HCC was associated with a higher risk of progression or death (HR 1.68, 95% CI 1.03-2.75). Statins did not reduce the risk of treatment discontinuation due to liver-related events (HR 1.05, 95% CI 0.27-4.14). Statins did not improve OS or PFS, nor did they reduce the risk of treatment discontinuation due to liver-related events in aHCC patients receiving A + B. Notably, MASLD-related HCC exhibited worse PFS, suggesting a potential differential response to systemic therapies, which warrants further investigation.

Scientific ReportsVol. 15(1)
University of Verona (IT), University of Parma (IT), Humanitas University (IT), University of Milan (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ospedale Maggiore (IT), Azienda Ospedaliero Universitaria Ospedali Riuniti (IT), Department of Health (ES), Centro Clinico Nemo (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Azienda USL di Bologna (IT), Ospedale per gli Infermi (IT), IRCCS Humanitas Research Hospital (IT), Azienda Ospedaliera Universitaria Pisana (IT), University of Florence (IT), University of Palermo (IT), University of Bologna (IT)
Eli Lilly and Company, AstraZeneca, Agios Pharmaceuticals, BeiGene, Eisai, Ipsen
Openalex Percentile: Top 18%
Cancer, Lipids, and Metabolism
0.94
DOIOpen Access PDFOpenAlex
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