Evidence map›Paper›PMID 27203227›Full record

ArticleCancer2016

Increased tumor response to neoadjuvant therapy among rectal cancer patients taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.

Zachary S Morris, Sandeep Saha, William J Magnuson, Brett A Morris, Jenna F Borkenhagen, Alisa Ching, Gayle Hirose, Vanesa McMurry, David M Francis, Paul M Harari and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 3 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Zachary S MorrisDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Sandeep SahaDepartment of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
William J MagnusonDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Brett A MorrisDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Jenna F BorkenhagenDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Alisa ChingQueen's Medical Center, University of Hawaii, Honolulu, Hawaii.
Gayle HiroseQueen's Medical Center, University of Hawaii, Honolulu, Hawaii.
Vanesa McMurryDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
David M FrancisDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Paul M HarariDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Rick ChappellDepartment of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Stuart TsujiQueen's Medical Center, University of Hawaii, Honolulu, Hawaii.
Mark A RitterDepartment of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
University of Wisconsin–Madison · USUniversity of Hawaii System · USQueen's Medical Center · US

Funding

INTEGRATED TRAINING FOR PHYSICIAN-SCIENTISTST32GM008692 · NIGMS · UNIVERSITY OF WISCONSIN-MADISON · PI BURKARD, MARK E · 1998 to 2020
$10.3M
Biology of Aging and Age-Related Diseases Training GrantT32AG000213 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI Rozalyn M. Anderson, Sanjay Asthana · 1991 to 2026
$9.9M
NIA NIH HHS T32 AG000213NIGMS NIH HHS T32 GM008692
6 · The paper itself

Abstract

backgroundAngiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly used antihypertensive medications that have been reported to affect aberrant angiogenesis and the dysregulated inflammatory response. Because of such mechanisms, it was hypothesized that these medications might affect the tumor response to neoadjuvant radiation in patients with rectal cancer.

methodsOne hundred fifteen patients who were treated with neoadjuvant radiation at the University of Wisconsin (UW) between 1999 and 2012 were identified. Univariate analyses were performed with anonymized patient data. In a second independent data set, 186 patients with rectal cancer who were treated with neoadjuvant radiation at the Queen's Medical Center of the University of Hawaii (UH) between 1995 and 2010 were identified. These data were independently analyzed as before. Multivariate analyses were performed with aggregate data.

resultsAmong patients taking ACEIs/ARBs in the UW data set, a significant 3-fold increase in the rate of pathologic complete response (pCR) to neoadjuvant therapy (52% vs 17%, P = .001) was observed. This finding was confirmed in the UH data set, in which a significant 2-fold-increased pCR rate (24% vs 12%, P = .03) was observed. Identified patient and treatment characteristics were otherwise balanced between patients taking and not taking ACEIs/ARBs. No significant effect was observed on pCR rates with other medications, including statins, metformin, and aspirin. Multivariate analyses of aggregate data identified ACEI/ARB use as a strong predictor of pCR (odds ratio, 4.02; 95% confidence interval, 2.06-7.82; P < .001).

conclusionsThe incidental use of ACEIs/ARBs among patients with rectal cancer is associated with a significantly increased rate of pCR after neoadjuvant treatment. Cancer 2016;122:2487-95. © 2016 American Cancer Society.

Indexed as

AdultAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntineoplastic Combined Chemotherapy ProtocolsCombined Modality TherapyDrug SynergismFemaleHumansMaleMiddle AgedNeoadjuvant TherapyNeoplasm GradingNeoplasm StagingRadiotherapy, AdjuvantRectal NeoplasmsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonistsangiotensinangiotensin-converting enzyme (ACE) inhibitorneoadjuvantradiationrectal cancer

Identifiers

PMID27203227
PMCPMC4998053
OpenAlexW2408718111

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.