Impact of angiotensin system inhibitors on esophageal cancer survival

Wang, Xuanji; Sweigert, Patrick J.; Eguia, Emanuel; Varsnik, M. Alyssa; Renz, Christen R.; Terrasse, Weston A.; Gauthier, Madeline; Aranha, Gerard V.; Knab, Lawrence M.

doi:10.1016/j.sopen.2020.08.001

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…This may explain the significant benefits for gastric cancer rather than for esophageal cancer. Another single center study found that there was no significant difference in OS (HR = 0.66, 95%CI = 0.35–1.25) or disease-free survival (HR = 0.75, 95%CI = 0.42–1.34) between the ACEIs/ARBs users and non-users among esophagectomy patients with esophageal cancer [ 42 ]. Nevertheless, our results of no significant benefit in esophageal cancer were conflicted with the finding by Chen et al [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study

Huang

Yang

et al. 2022

BMC Cancer

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Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are used in treating cardiovascular diseases. Previous studies indicated that ACEIs/ARBs may benefit cancer patients by inhibiting tumor angiogenesis and proliferation. The effect of ACEIs/ARBs on cancer survival in esophageal and gastric cancer is still unclear. This study is to investigate the association between ACEIs/ARBs usage and esophageal and gastric cancer prognosis. Methods This retrospective cohort study identified esophageal and gastric cancer patients during 2008–2016 from the Taiwan Cancer Registry, and obtained medication usage and follow-up information from the National Health Insurance Research Database and Death Registry. Analysis groups were defined as ACEIs/ARBs user or non-user based on the usage of ACEIs/ARBs within the 6 months after cancer diagnosis. The stabilized inverse probability of treatment weighting using propensity scores was applied to balance covariates between study groups. We also used Kaplan-Meier estimates and Cox regression to compare survival outcome and estimate hazard ratios (HRs). Results We identified 14,463 and 21,483 newly-diagnosed esophageal and gastric cancer patients during 2008–2016. ACEIs/ARBs users were associated with lower risk of cancer-specific mortality, although only significantly in gastric cancer (gastric: adjusted HR = 0.87, 95% CI = 0.78–0.97; esophageal: adjusted HR =0.88, 95% CI = 0.76–1.02). A better survival outcome was observed among patients who received higher cumulative defined daily dose of ACEIs/ARBs. Conclusions We found that using ACEIs/ARBs after cancer diagnosis were associated with lower risk of mortality. Our results add to the knowledge of the benefit of ACEIs/ARBs against mortality in individuals with esophageal/gastric cancer patients with hypertension.

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Section: Discussionmentioning

confidence: 99%

Prognostic impact of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers in esophageal or gastric cancer patients with hypertension - a real-world study

Huang

Yang

et al. 2022

BMC Cancer

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“…However, it is unclear if those results can be transferred to esophageal cancer since ambiguous data have been published. On the one hand, RAS factors, such as angiotensin-converting enzyme (ACE) and the angiotensin II subtype 1 receptor (AT1R), seem to be upregulated in Barrett’s esophagus [ 68 ] but, on the other hand, no prognostic effects of RAS-inhibition have been found in both ESCC and EAC so far [ 69 ].…”

Section: Cancer-associated Fibroblastsmentioning

confidence: 99%

Tumor Microenvironment of Esophageal Cancer

Schiffmann

Plum

Fuchs

et al. 2021

Cancers

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Esophageal cancer is among the top ten most deadly cancers worldwide with adenocarcinomas of the esophagus showing increasing incidences over the last years. The prognosis is determined by tumor stage at diagnosis and in locally advanced stages by response to (radio-)chemotherapy followed by radical surgery. Less than a third of patients with esophageal adenocarcinomas completely respond to neoadjuvant therapies which urgently asks for further strategies to improve these rates. Aiming at the tumor microenvironment with novel targeted therapies can be one strategy to achieve this goal. This review connects experimental, translational, and clinical findings on each component of the esophageal cancer tumor microenvironment involving tumor angiogenesis, tumor-infiltrating immune cells, such as macrophages, T-cells, myeloid-derived suppressor cells, and cancer-associated fibroblasts. The review evaluates the current state of already approved concepts and depicts novel potentially targetable pathways related to esophageal cancer tumor microenvironment.

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