Influence of Renin-Angiotensin System Inhibitors on the Treatment of Metastatic Renal Cancer

Nikoo Saeedi; Saeide Mansoori; Fereshteh Asgharzadeh; Atena Soleimani; Samaneh Mollazadeh; Seyed Mehdi Hasanian

doi:10.2174/1381612829666230524152108

Influence of Renin-Angiotensin System Inhibitors on the Treatment of Metastatic Renal Cancer

Curr Pharm Des. 2023 May 24. doi: 10.2174/1381612829666230524152108. Online ahead of print.

Authors

Nikoo Saeedi¹, Saeide Mansoori², Fereshteh Asgharzadeh³, Atena Soleimani², Samaneh Mollazadeh⁴, Seyed Mehdi Hasanian^{1

5}

Affiliations

¹ Student Research Committee, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
² Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁴ Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
⁵ Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

PMID: 37226780
DOI: 10.2174/1381612829666230524152108

Abstract

Background: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are mainly known as anti-hypertensive drugs. Recent evidence suggests their anti-tumor potential against renal cancer. More than one-fourth of patients present with metastasis on their first visit.

Objective: The purpose of the current study was to examine the potential clinical impact of ACEI/ARB on metastatic renal cell carcinoma (mRCC).

Methods: We searched through several online databases, including Pubmed, Scopus, Web of Science, and Embase, to find clinical studies that have investigated the association between treatment with ACEI/ARB and the survival of patients with mRCC. The hazard ratio (HR) and 95% confidence interval (95% CI) were utilized to assess the strength of the association.

Results: A total of 6 studies with a total number of 2,364 patients were found eligible for the final analysis. The HR for the relationship between ACEI/ARB use and overall survival (OS) showed patients undergoing treatment with ACEI/ARB to have higher OS than non-users (HR: 0.664, 95% CI 0.577-0.764, p=0.000). Furthermore, the HR for the relationship between ACEI/ARB use and progression-free survival (PFS) showed patients undergoing treatment with ACEI/ARB to have higher PFS than non-users (HR: 0.734, 95% CI 0.695-0.794, p=0.000).

Conclusion: The results of this review offer ACEI/ARB as a potential therapeutic option associated with improved survival outcomes in patients receiving anti-vascular endothelial growth factor therapy.

Keywords: ACEI/ARB; Angiotensin receptor blocker; Angiotensin-converting enzyme inhibitor; Metastatic Renal Cancer; Renin-Angiotensin System Inhibitors; progression-free survival.