Angiotensin system inhibitors and outcome of sunitinib treatment in patients with metastatic renal cell carcinoma: a retrospective examination.
Angiotensin system inhibitors and outcome of sunitinib treatment in patients with metastatic renal cell carcinoma: a retrospective examination.
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DOI：
10.1016/j.ejca.2011.04.019
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发表时间：
2011-09
影响因子：
8.4
通讯作者：
Carducci, Michael A.
中科院分区：
文献类型：
--
作者：
Keizman, Daniel;Huang, Peng;Eisenberger, Mario A.;Pili, Roberto;Kim, Jenny J.;Antonarakis, Emmanuel S.;Hammers, Hans;Carducci, Michael A.
关键词：
舒尼替尼是转移性肾细胞癌的标准治疗方法。血管紧张素系统抑制剂，包括血管紧张素转换酶抑制剂和血管紧张素II受体阻滞剂，广泛应用于高血压、肾病、心力衰竭等疾病的治疗。数据表明它们可以抑制肿瘤发生。研究血管紧张素系统抑制剂对转移性肾细胞癌舒尼替尼治疗结果的影响。我们对一组未经选择的接受舒尼替尼治疗的转移性肾细胞癌患者进行了回顾性研究。患者被分为血管紧张素系统抑制剂使用者（第1组）和非使用者（第2组）。通过逻辑回归模型和 Cox 回归模型对已知的混杂风险因素进行调整，测试血管紧张素系统抑制剂对客观反应、疾病进展时间和总生存期的影响。 2004年至2010年间，127名转移性肾细胞癌患者接受了舒尼替尼治疗，其中第1组44名，第2组83名。各组在已知的临床病理预后因素方面保持平衡。第 1 组和第 2 组的客观缓解率分别为部分缓解/疾病稳定 86% 和 72%，疾病进展为 14% 和 28% (p = 0.07)。中位无进展生存期为 13 个月与 6 个月（HR 0.537，p = 0.0055），中位总生存期为 30 个月与 23 个月（HR 0.688，p = 0.21），有利于第 1 组。血管紧张素系统抑制剂可以改善转移性肾细胞癌舒尼替尼治疗的结果。应对此进行前瞻性研究，如果经过验证，则应应用于临床实践和临床试验。
Sunitinib is a standard treatment for metastatic renal cell carcinoma. Angiotensin system inhibitors, including angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, are widely used in hypertension, kidney disease, and heart failure. Data suggests that they may inhibit tumourigenesis. To study the effect of angiotensin system inhibitors on sunitinib treatment outcome in metastatic renal cell carcinoma. We performed a retrospective study of an unselected cohort of patients with metastatic renal cell carcinoma who were treated with sunitinib. Patients were divided into angiotensin system inhibitors users (group 1) and non-users (group 2). The effect of angiotensin system inhibitors on objective response, time to disease progression and overall survival, was tested with adjustment for known confounding risk factors through logistic regression model and Cox regression model. Between 2004 and 2010, 127 patients with metastatic renal cell carcinoma were treated with sunitinib, 44 group 1 and 83 group 2. The groups were balanced regarding known clinicopathologic prognostic factors. Objective response was partial response/stable disease 86% versus 72% and progressive disease 14% versus 28% (p = 0.07) in group 1 versus 2, respectively. Median progression free survival was 13 versus 6 months (HR 0.537, p = 0.0055), and median overall survival 30 versus 23 months (HR 0.688, p = 0.21), in favour of group 1. Angiotensin system inhibitors may improve the outcome of sunitinib treatment in metastatic renal cell carcinoma. This should be investigated prospectively, and if validated applied in clinical practise and clinical trials.
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