Does angiotensin receptor blocker use influence gastro-oesophageal cancer survival?

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Takeaway
  • Cancer-specific mortality was found to be moderately reduced in patients with gastro-oesophageal cancer using angiotensin receptor blockers (ARBs).
Why this matters
  • In England, ARBs are recommended as a first-line pharmacological treatment for hypertension patients aged under 55 y or with comorbid diabetes.
  • In-vitro models at various cancer sites have shown that ARBs reduce tumour growth, stimulate cell apoptosis, reduce metastasis, and inhibit angiogenesis.
Study design
  • This cohort study evaluated 5124 patients (ARB users, n=360; non-users, n=4764) with gastro-oesophageal cancer between 1998 and 2012.
  • Association between post-diagnosis ARB use and gastro-oesophageal cancer mortality was evaluated.
  • Funding: Clinical Research Bursary for AS from Cancer Research-UK.
Key results
  • Median follow-up duration was 1.4 y.
  • 3345 patients died during the follow-up period because of gastro-oesophageal cancer.
  • ARB users showed moderately reduced risk for gastro-oesophageal cancer mortality after adjustment (HR, 0.83) vs non-users.
  • Mortality rate was found to be significantly lower among patients receiving ARBs for at least 2 y (HR, 0.42; P-value for trend=.003).
  • Dose-response relationship showed slightly stronger association among patients with gastric cancer (aHR, 0.79) vs oesophageal cancer (aHR, 0.89).
Limitations
  • Cancer-specific deaths were not identifiable.