Impact of angiotensin I converting enzyme inhibitors and angiotensin II type 1 receptor blockers on survival in patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy
Impact of angiotensin I converting enzyme inhibitors and angiotensin II type 1 receptor blockers on survival in patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy
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DOI：
10.1007/s00432-009-0587-3
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发表时间：
2009-10-01
影响因子：
3.6
通讯作者：
Jost, Edgar
中科院分区：
文献类型：
--
作者：
Wilop, Stefan;von Hobe, Sabine;Jost, Edgar
肾素-血管紧张素系统在维持血管稳态中起着至关重要的作用。血管紧张素II 1型受体（AT 1 R）的刺激通过增加血管内皮生长因子（VEGF）的水平而发挥促血管生成作用。因此，细胞培养实验和动物研究表明AT 1 R阻断剂（ARB）和血管紧张素I转换酶抑制剂（ACEI）在几种恶性肿瘤中具有抗增殖作用。迄今为止，关于ACEI与ARB联合化疗的抗血管生成作用的临床数据非常有限。回顾性分析了287例接受一线铂类化疗的晚期非小细胞肺癌患者，包括长期使用ACEI和ARB的患者，以及组织学类型、分期、体力状态、性别、年龄、接受ACEI或ARB治疗的患者的中位生存期比未接受者长3.1个月（11.7 vs.8.6个月，HR 0.56，P = 0.03）。这种生存优势不能归因于其他已确定的危险因素或化疗的剂量强度。在以铂类为基础的一线化疗中加入ACEI或ARB可能有助于延长晚期肺癌患者的生存期。
The renin-angiotensin system plays a crucial role in maintaining vascular homeostasis. Stimulation of angiotensin II type 1 receptors (AT1R) acts proangiogenically by increasing levels of vascular endothelial growth factor (VEGF). Consequently, cell culture experiments and animal studies have shown antiproliferative effects of AT1R blockers (ARB) and angiotensin I converting enzyme inhibitors (ACEI) in several malignancies. Until now, very limited clinical data for this antiangiogenic effect exists for combinations with antineoplastic chemotherapy.A total of 287 patients with advanced non-small-cell lung cancer undergoing first-line platinum-based chemotherapy were retrospectively analysed regarding long-term medication with ACEI and ARB as well as histological type, stage, performance status, gender, age, dose-intensity of chemotherapy and survival.Patients receiving either ACEI or ARB had a 3.1 months longer median survival than non-recipients (11.7 vs. 8.6 months, HR 0.56, P = 0.03). This survival advantage could not be attributed to other established risk-factors or dose intensity of chemotherapy.Addition of ACEI or ARB to platinum-based first-line chemotherapy may contribute to prolonged survival in patients with advanced lung cancer.