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Do statins improve outcomes for patients with non-small cell lung cancer? A systematic review and meta-analysis protocol
  1. Feng Li1,2,
  2. Guangyu Liu3,
  3. Raheleh Roudi4,
  4. Qi Huang5,
  5. Marc Swierzy1,
  6. Mahmoud Ismail1,
  7. Song Zhao2,
  8. Jens-Carsten Rueckert1
  1. 1 Department of General, Visceral, Vascular and Thoracic Surgery, Charite Universitatsmedizin Berlin, Berlin, Germany
  2. 2 Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
  3. 3 Department of Anesthesiology, Peking University First Hospital, Beijing, China
  4. 4 Department of Oncopathology, Research Center, Iran University of Medical Sciences, Tehran, Iran
  5. 5 Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
  1. Correspondence to Professor Jens-Carsten Rueckert; jens-c.rueckert{at}


Introduction Lung cancer is the most common neoplasm and the leading cause of cancer-related death worldwide. Non-small cell lung cancer (NSCLC), accounting for 85% of all lung cancer cases, is frequently diagnosed at an advanced and metastatic stage. In addition, survival of patients with NSCLC has not improved significantly over the recent decades. Statins are used as a cholesterol-lowering agent, but recently preclinical and clinical studies have revealed their anticancer effects. Thus, this systematic review and meta-analysis aims to clarify whether statins improve the prognosis of patients with NSCLC.

Methods and analysis We will search MEDLINE (PubMed), EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials and with no restriction on language. Both randomised controlled trials (RCTs) and observational cohort studies evaluating the prognostic role of statins in patients with NSCLC will be included. The primary outcome will be overall survival, and the secondary outcomes will include cancer-specific survival, disease-free survival and cancer recurrence. Two assessors will assess the RCTs using the Cochrane Collaboration’s risk of bias tool and the observational cohort studies according to ROBINS-I. Publication bias will be assessed by funnel plot using the STATA software v.13.1.

Ethics and dissemination No ethical issues are predicted. This systematic review and meta-analysis aims to describe the prognostic effects of statins in patients with NSCLC, which would help clinicians to optimise treatment for patients with NSCLC. These findings will be published in a peer-reviewed journal and presented at national and international conferences.

PROSPERO registration number CRD42016047524.

  • Statins
  • non-small-cell lung cancer
  • prognostic effects

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  • FL, GL and RR contributed equally.

  • Contributors FL and GL came up with the original idea of this work. QH assisted in protocol design. MS, MI, SZ and J-CR provided valuable advice for the research protocol. RR, FL and GL drafted the protocol, which was revised by all the authors. GL and FL will search for studies, extract and analyse the data, and QH will be consulted if they do not reach an agreement.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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