Abstract
This study investigates the potential clinical synergy between the poly(adenosine 5'-diphosphate [ADP]-ribose) polymerase (PARP) inhibitor niraparib (Zejula®) and concomitant statins, exploring their combined effects on progression-free survival (PFS) in ovarian cancer patients. We retrospectively analysed niraparib registrational clinical trials in ovarian cancer to investigate potential interactions between niraparib and statins. In the PRIMA trial, patients receiving niraparib demonstrated improved PFS compared to those on placebo (hazard ratio=0.62; P<0.001; mPFS 13.8 months vs 8.2 months). The post hoc analysis revealed that patients receiving maintenance niraparib who reported concomitant use of statins exhibited significantly improved PFS compared to those on placebo with concomitant statins (hazard ratio=0.34; P<0.001; mPFS 18.2 months vs 6.0 months). Notably, the improved efficacy in the two-arm comparison of concomitant statin patients were much better than in the two-arm comparison of those patients without statin, as reflected in the niraparib:statin interaction (P=0.005). These findings suggest novel opportunities in oncology for the use of statins in combination therapies with PARP inhibitors and emphasize the need for further investigation.