Statin Use Is Associated With Progression‐Free Survival for Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma Treated With Pembrolizumab

BACKGROUND: Statins may modulate immune function and enhance immunotherapy response. This study evaluated the relationship between statin use and outcomes in patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) receiving pembrolizumab. METHODS: A retrospective observational study was conducted at UCSF including patients with oral cavity, oropharyngeal, hypopharyngeal, laryngeal, or cutaneous HNSCC treated with pembrolizumab from 2016 to 2022. Primary outcome was 6-month progression-free survival (PFS); secondary was 2-year overall survival (OS). RESULTS: Among 165 patients, 60 (36%) used statins. After adjustment for ECOG status, concurrent systemic therapy, and tumor site, any statin use (HR 0.49, p = 0.012), high-intensity statins (HR 0.46, p = 0.012), and lipophilic statin use (HR 0.54, p = 0.041) were associated with improved 6-month PFS. CONCLUSIONS: Statin use, particularly high-intensity regimens, was associated with improved short-term outcomes on pembrolizumab in HNSCC. Prospective studies are warranted to elucidate underlying mechanisms.