Originally published as JCO Early Release 10.1200/JCO.2008.19.3201 on October 20 2008

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In Reply

Joseph R. Carver, Stephen J. Schuster, John H. Glick

Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA

We thank Dr Rabinowitz for alerting us to the Winiarska et al study¹ that shows an ex vivo interaction between statins and rituximab. Similar ex vivo drug-drug interactions with statins and clopidogrel have been reported² and with further clinical investigation, no relevant in vivo effects were identified.³

The hypothetical potential for stains to reduce the anticancer efficacy of rituximab is intriguing and has prompted us to begin a retrospective comparison of response outcomes of patient groups receiving concurrent rituximab monotherapy and/or statins.

Until there are more data, we have not altered our basic approach to therapy at this time.

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author(s) indicated no potential conflicts of interest.

NOTES

published online ahead of print at www.jco.org on October 20, 2008

REFERENCES

1. Winiarska M, Bil J, Wilczek E: Stains impair antitumor effects of rituximab by inducing conformational changes of CD20. PLos Med 5:e64, 2008[Medline]

2. Neubauer H, Gunesdogan B, Hanefeld C, et al: Lipophilic statins interfere with the inhibitory effects of clopidogrel on platelet function- a flow cytometry study. European Heart J 24:1744-1749, 2003[Abstract/Free Full Text]

3. Saw J, Brennan DM, Steinhubl SR, et al: Lack of evidence of a clopidrogrel-statin interaction in the CHARISMA trial. J Am Coll Cardiol 50:291-295, 2007[Abstract/Free Full Text]

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