ArticleEuropean journal of cancer (Oxford, England : 1990)2022
Renin-angiotensin-aldosterone system inhibitors and survival in patients with hypertension treated with immune checkpoint inhibitors.
Article in European journal of cancer (Oxford, England : 1990), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Renin-angiotensin system inhibitors and immunotherapy outcomes in lung cancer: a systematic review and meta-analysis with complementary transcriptomic analyses.Frontiers in immunology · 2026Pooled it
- Concomitant use of renin-angiotensin system inhibitors augments the efficacy of immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Effect of renin-angiotensin-aldosterone system inhibitors on survival outcomes in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in immunology · 2023Pooled it
- Addition of Losartan to FOLFIRINOX and Chemoradiation Reduces Immunosuppression-Associated Genes, Tregs, and FOXP3+ Cancer Cells in Locally Advanced Pancreatic Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023Trial
- The Impact of Angiotensin-Converting Enzyme Inhibitors on Immune-Related Adverse Events and Clinical Outcomes in Patients with Metastatic NSCLC.Biomedicines · 2026Article
- Article
- Impact of Angiotensin-Converting Enzyme Inhibitors (ACEIs) on the Efficacy of Immunotherapy in Metastatic NSCLC.Medical sciences (Basel, Switzerland) · 2026Observational
- Reverse cardio-oncology: neuroendocrine axis activation and cardiovascular-disease-derived factors synergistically remodel the tumor microenvironment.Cellular oncology (Dordrecht, Netherlands) · 2026Review
- Risk modifiers of immune-related adverse events in patients with NSCLC undergoing immunotherapy: a retrospective cohort study.Journal of pharmaceutical health care and sciences · 2026Article
- Mechanobiology of non-small cell lung cancer: bridging tumor mechanics and therapeutic strategies.Molecular biology reports · 2026Review
- The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.Nature reviews. Cancer · 2026Review
- Bidirectional Mendelian randomization analysis of hypertension, coronary artery disease, and gastric cancer with supplementary clinical data.Frontiers in cardiovascular medicine · 2026Article
- Review
- Concomitant medication effects on patients with lung cancer taking immune checkpoint inhibitors a review.Medical oncology (Northwood, London, England) · 2025Review
- Current Status and Future Perspective of Onco-Hypertension.American journal of hypertension · 2024Review
- Targeting the Renin-angiotensin-aldosterone System (RAAS) for Cardiovascular Protection and Enhanced Oncological Outcomes: Review.Current treatment options in oncology · 2024Review
- Impact of Angiotensin Converting Enzyme Inhibitors on Pathologic Complete Response With Neoadjuvant Chemotherapy for Muscle Invasive Bladder Cancer.Clinical genitourinary cancer · 2024Article
- Angiotensin receptor blocker attacks armored and cold tumors and boosts immune checkpoint blockade.Journal for immunotherapy of cancer · 2024Article
- Multimodal Blockade of the Renin-Angiotensin System in the Treatment of Cancer in Dogs Has Mild Adverse Effects in Some Dogs.Veterinary sciences · 2024Article
- An increase in albuminuria is associated with a higher incidence of malignancies.Clinical kidney journal · 2024Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundPreclinical studies indicate that the concurrent use of inhibitors of the renin-angiotensin-aldosterone system (RAAS) may improve outcomes in broad groups of patients with cancer. There are limited data on the association between the use of RAAS inhibitors and outcomes among patients treated with immune checkpoint inhibitors (ICIs).
methodsWe performed a retrospective study of all patients treated with an ICI in a single academic network. Of 10,903 patients, 5910 were on any anti-hypertensive medication. Of those on anti-hypertensive therapy, 3426 were prescribed a RAAS inhibitor during ICI treatment, and 2484 were prescribed other anti-hypertensive medications. The primary outcome was overall survival in the entire cohort and in sub-groups by cancer types.
resultsThoracic cancer (34%) and melanoma (16%) were the most common types of cancer. Those prescribed a RAAS inhibitor were older, more frequently male, and had more cardiovascular risk factors. In a Cox proportional hazard model, the concurrent use of RAAS inhibitors was associated with better overall survival (hazard ratio (HR):0.92, [95% Confidence Interval (CI):0.85-0.99], P = .032). Patients with gastrointestinal (HR:0.82, [95% CI: 0.67-1.01], P = .057) and genitourinary cancer (HR:0.81, [95% CI:0.64-1.01], P = .067) had a non-statistically significant better overall survival.
conclusionsIn this large retrospective study, patients with hypertension who were concomitantly taking a RAAS inhibitor during ICI therapy had better overall survival. This benefit was primarily noted among patients with gastrointestinal and genitourinary cancers. Prospective randomized trials are warranted to further evaluate and specify the benefit of RAAS inhibitors in patients with cancer who receive ICI therapy.
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Registered trials
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.