SynthesisFrontiers in pharmacology2026
Renin-angiotensin system inhibitor use and survival outcomes in lung cancer: a systematic review and meta-analysis.
Synthesis in Frontiers in pharmacology, 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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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.
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Authors and funding
5 authors.
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Abstract
Background: Renin-angiotensin system inhibitors (RASi) have been associated with favorable survival outcomes across various cancers, but their association with survival in lung cancer remains uncertain. We conducted a systematic review and meta-analysis to evaluate the association between RASi use and survival outcomes in patients with lung cancer. Methods: PubMed and Embase were searched from inception to 6 July 2026. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup and sensitivity analyses, including large-study restricted analysis and precision-effect test and precision-effect estimate with standard error (PET-PEESE) regression, were performed to explore heterogeneity and assess the potential influence of small-study effects. Results: Twenty-six studies involving 403,423 patients were included. RASi use was associated with longer overall survival (OS; HR = 0.76, 95% CI: 0.70-0.83; Conclusion: Conventional meta-analysis showed an association between RASi use and longer OS and PFS. However, the OS association was attenuated to the null after adjustment for small-study effects, indicating that the magnitude and robustness of the observed OS association remain uncertain. These findings should therefore be interpreted cautiously and require confirmation in well-designed prospective studies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251053671, identifier: CRD420251053671.
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