The impact of Renin-angiotensin system blockers on lung cancers prognosis

Background and objective: The impact of antihypertensive medications angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on the clinical outcomes of lung cancer patients remains controversial. This meta-analysis was conducted to investigate the association between ACEIs/ARBs usage and survival of lung cancer patients.

 Methods: Eligible studies were identified by searching Pubmed, Embase and Cochrane library up to February, 2017. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for the effect of ACEIs/ARBs on survival of lung cancer. Heterogeneity and sensitivity were also analyzed.

Results: We finally included 9 eligible studies (8 articles) with the total number of 29,156 patients in this meta-analysis. Our results showed that ACEIs/ARBs usage was associated with favorable overall survival (OS) (HR, 0.86; 95% CI, 0.76–0.98) in lung cancer patients. Moreover, the significant association was found in subgroup of advanced clinical stage (IIIb to IV) (HR, 0.77; 95% CI, 0.64-0.92) and non-small cell lung carcinoma (NSCLC) (HR, 0.78; 95% CI, 0.65–0.93). However, no significant association was revealed between ACEIs/ARBs usage and progression-free survival (PFS) (HR, 0.84; 95% CI, 0.70–1.02).

Conclusions: ACEIs/ARBs statistically significantly prolong OS of lung cancer patients, especially in advanced clinical stage or patients with NSCLC. However, it has no demonstrable impact on PFS.

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