SAN FRANCISCO—Patients with metastatic renal cell carcinoma (mRCC) may experience significant improvements in overall and progression-free survival if they receive concomitant antihypertensive treatment with an angiotensin system inhibitor (ASI), according to study findings presented at the 2014 Genitourinary Cancers Symposium.
The findings are from an analysis of data from clinical trials of medications to treat mRCC. The study population totaled 4,736 patients. The median overall survival was 26 months for patients receiving ASIs—which include ACE inhibitors and angiotensin receptor blockers—compared with 17 months for non-ASI users. The median progression-free survival was 8.3 months for ASI users versus 6.5 months for non-users.
“Though larger prospective studies are needed,” said lead author Rana McKay, MD, a clinical oncology fellow at Dana-Farber Cancer Institute in Boston, “based on the results of this study, an ASI should be considered for patients with metastatic renal cell carcinoma who need an antihypertensive and do not have any contraindications that preclude their use, especially in patients receiving VEGF targeted treatments.”
Agents that target the VEGF pathway include sunitinib, sorafenib, axitinib, and bevacizumab.
For the study, Dr. McKay’s group defined ASI users as patients taking an ASI at baseline or within the first 30 days of the study.
Baseline hypertension was present in 84% of the 1,383 ASI users and 33% of the 3,353 ASI non-users.
The symposium is co-sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Urologic Oncology.