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. 2009 Oct;135(10):1429-35.
doi: 10.1007/s00432-009-0587-3. Epub 2009 Apr 28.

Impact of angiotensin I converting enzyme inhibitors and angiotensin II type 1 receptor blockers on survival in patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy

Stefan Wilop  1 , Sabine von Hobe, Martina Crysandt, Albert Esser, Rainhardt Osieka, Edgar Jost
Affiliations

Impact of angiotensin I converting enzyme inhibitors and angiotensin II type 1 receptor blockers on survival in patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy

Stefan Wilop et al. J Cancer Res Clin Oncol. 2009 Oct.

Abstract

Purpose: The renin-angiotensin system plays a crucial role in maintaining vascular homeostasis. Stimulation of angiotensin II type 1 receptors (AT1R) acts proangiogenically by increasing levels of vascular endothelial growth factor (VEGF). Consequently, cell culture experiments and animal studies have shown antiproliferative effects of AT1R blockers (ARB) and angiotensin I converting enzyme inhibitors (ACEI) in several malignancies. Until now, very limited clinical data for this antiangiogenic effect exists for combinations with antineoplastic chemotherapy.

Methods: A total of 287 patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy were retrospectively analysed regarding long-term medication with ACEI and ARB as well as histological type, stage, performance status, gender, age, dose-intensity of chemotherapy and survival.

Results: Patients receiving either ACEI or ARB had a 3.1 months longer median survival than non-recipients (11.7 vs. 8.6 months, HR 0.56, P = 0.03). This survival advantage could not be attributed to other established risk-factors or dose intensity of chemotherapy.

Conclusions: Addition of ACEI or ARB to platinum-based first-line chemotherapy may contribute to prolonged survival in patients with advanced lung cancer.

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Figures

Fig. 1
Fig. 1
Overview of the involved major pathways leading to tumour proliferation, modified after (Deshayes and Nahmias ; Uemura et al. 2006)
Fig. 2
Fig. 2
Estimated survival from first cycle of chemotherapy in the entire patient group according to long-term medication with (n = 52) or without (n = 235) ACEI or ARB (P = 0.03, log-rank test)
See this image and copyright information in PMC

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