Abstract B93: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may decrease cancer-related mortality in patients with small-cell lung cancer

Abstract

Introduction: Small-cell lung cancer (SCLC) is the most aggressive type of lung cancer. The overall survival at five years for patients with SCLC is estimated to be five to ten percent. Angiotensin-Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs) have been reported to decrease the risk of lung cancer. The aim of this retrospective study was to investigate the association between ACE inhibitors and ARBs and cancerrelated mortality in patients with SCLC. Methods: In this study, we retrospectively reviewed the charts of 360 patients diagnosed with SCLC in our institution between 1995 and 2004. 199 patients with advanced SCLC, deceased at the time of this report, and for whom the cause of death was known, were identified. Within this group, cancer-related mortality in patients who were on ACE inhibitors and/or ARBs was compared to that of patients not on these medications. Results: Out of 199 patients, 58 (29%) were on ACE inhibitors and/or ARBs, 141 (71%) were not. In ACE inhibitor and/or ARB users, cancer was the cause of death in 34 patients. In patients not on ACE inhibitors and/or ARBs, 103 died from cancer. Patients on ACE inhibitors and/or ARBs had a 14% decrease in cancer-related mortality compared to patients who were not on these medications (59% versus 73% respectively, P= 0.046). Conclusion: Our data support the fact that ACE inhibitors and ARBs may be associated with a decrease in cancer-related mortality in patients with SCLC. This could be related to their inhibitory effects on angiogenesis and tumor growth, by blocking angiotensin II and increasing the levels of angiotensin (1–7). However, prospective studies are needed to establish the effect of ACE inhibitors and ARBs on cancer-related mortality in patients with SCLC. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B93.