Hard as a ROCK.

What can’t statins do, really? The French phase 2 Pravacur trial evaluated their efficacy at diminishing neck fibrosis following radiation. As anyone who’s ever taken a rad bio test knows, TGF-β is a common culprit of fibrosis pathways. In preclinical models, statins have been effective at curtailing another, less tested but more aptly-named, fibrosis pathway of Rho/ROCK/CTGF signaling. In Pravacur, 60 patients with at least grade 2 neck fibrosis 6 to 24 months out from treatment received pravastatin 40 mg daily for one year. The primary endpoint was rate of reduction in neck fibrosis by at least 30%, as quantified by high-frequency (≥16-MHz) ultrasound. Of the 40 people who remained on pravastatin for one year, such a reduction occurred in over one-third (n=15). While 20 patients stopped statins of their own accord, the authors point out this still means they’re better tolerated than the longtime standard pentoxifylline with vitamin E. TBL: Statins deserve phase 3 confirmation of efficacy in the treatment of radiation fibrosis, but in the meantime it remains a cheap and accessible off-label option. | Bourgier, Int J Radiat Oncol Biol Phys 2019