Abstract
OBJECTIVE: To assess the effects of statins on immune-related adverse reactions, quality of life, and clinical outcomes in older adults receiving cancer immunotherapy. METHODS: We retrospectively enrolled 150 elderly cancer patients admitted to Beijing Shunyi Hospital between August 2023 and March 2025, who were categorized into a study group (n=94) and a control group (n=56) depending on their use of oral statins. Clinical efficacy, laboratory parameters, quality of life, and adverse reactions were compared between groups. Patients on statins with biomarker elevations ≤2.5 times the upper limit of normal (ULN) (n=78) were further divided into discontinuation (n=35) and continuation (n=43) subgroups to compare biomarker normalization rates. Progression-free survival (PFS) was assessed, and Cox regression analyses were performed to identify PFS-associated factors. RESULTS: No significant differences were observed in general characteristics, clinical efficacy, or most laboratory indicators between the two groups (all P>0.05). Following treatment, the study group demonstrated more pronounced improvements in inflammatory/tumor markers and lipid profiles (all P<0.05), with better quality of life (P<0.05), while overall adverse reaction incidence and cardiac biomarker elevations remained comparable between groups (all P>0.05). Normalization rates in statin users with mild elevations did not differ by discontinuation status. Median PFS was numerically longer in the statin group (11.5 vs 10.9 months) but not statistically significant (all P>0.05). CONCLUSION: In elderly cancer patients receiving immunotherapy, concomitant statin use did not increase adverse reactions, may improve quality of life, and did not compromise clinical efficacy. The observed PFS benefit was modest. Statins should be considered as an adjunctive therapy, with decisions individualized based on lipid profile and cardiovascular risk.