ArticleTherapeutic advances in medical oncology2026
Angiotensin inhibitors during neoadjuvant chemotherapy improve esophageal squamous cell carcinoma outcomes.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The renin-angiotensin-aldosterone system (RAAS) is implicated in the initiation, progression, and therapeutic response of several solid malignancies. RAAS inhibitors (angiotensin system inhibitors) exhibit potential antitumor effects; however, their impact on patients with esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant therapy remains scarce. Objectives: To investigate whether incidental ASI use during neoadjuvant treatment is associated with enhanced pathological response and survival outcomes in patients with ESCC. Design: A retrospective study. Methods: We retrospectively analyzed 391 ESCC patients who underwent neoadjuvant therapy followed by R0 resection between 2015 and 2022, stratified according to incidental use of ASIs during neoadjuvant chemotherapy (NAC). Baseline characteristics, major pathologic response (MPR), and long-term survival outcomes were compared. MPR rates were compared using the Chi-square test and multivariable logistic regression. Kaplan-Meier analysis was used to estimate overall survival (OS) and disease-free survival (DFS), and multivariable Cox proportional hazards models were applied to adjust for potential confounders. Sensitivity analyses were performed using propensity score matching (PSM). Results: Overall, 67 (17.1%) patients were administered ASIs. Compared with non-users, ASI users were older ( Conclusion: In ESCC patients receiving NAC, incidental ASI use correlated with better pathological response and improved long-term survival. RAAS inhibition shows promise as a perioperative therapeutic approach and warrants postoperative validation.
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