Inhibition of renin-angiotensin system affects prognosis of advanced pancreatic cancer receiving gemcitabine

• Published in: British journal of cancer 2010-11, Vol.103 (11), p.1644-1648
• Main Authors: Nakai, Y, Isayama, H, Ijichi, H, Sasaki, T, Sasahira, N, Hirano, K, Kogure, H, Kawakubo, K, Yagioka, H, Yashima, Y, Mizuno, S, Yamamoto, K, Arizumi, T, Togawa, O, Matsubara, S, Tsujino, T, Tateishi, K, Tada, M, Omata, M, Koike, K
• Format: Article
• Language: English
• Subjects: 631/92/609; 692/699/67/1504/1713; 692/700/1750; 692/700/565/1436/99; Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers - administration & dosage; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Antihypertensive Agents - administration & dosage; Antimetabolites, Antineoplastic - therapeutic use; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; clinical-study; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Drug Resistance; Drug Therapy, Combination; Epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Molecular Medicine; Oncology; Pancreatic cancer; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - mortality; Prognosis; Retrospective Studies; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6605955

Background: The renin–angiotensin system (RAS) is thought to have a role in carcinogenesis, and RAS inhibition may prevent tumour growth. Methods: We retrospectively investigated the impact of angiotensin I-converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs) in 155 patients with pancreatic cancer receiving gemcitabine monotherapy. Patients were divided into three groups: the ACEI/ARB group (27 patients receiving an ACEI or ARB for hypertension (HT)), the non-ACEI/ARB with HT group (25 patients receiving antihypertensive drugs other than ACEIs or ARBs), and the non-HT group (103 patients receiving no antihypertensive drugs). Results: Patient characteristics were not different, except for age and HT medications. Progression-free survival (PFS) was 8.7 months in the ACEI/ARB group, 4.5 months in the non-ACEI/ARB with HT group, and 3.6 months in the non-HT group. Overall survival (OS) was 15.1 months in the ACEI/ARB group, 8.9 months in the non-ACEI/ARB with HT group, and 9.5 months in the non-HT group. The use of ACEIs/ARBs was a significant prognostic factor for both PFS ( P =0.032) and OS ( P =0.014) in the multivariate analysis. Conclusions: The ACEIs/ARBs in combination with gemcitabine might improve clinical outcomes in patients with advanced pancreatic cancer. Prospective trials are needed to test this hypothesis.