Generic placeholder image

Current Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

Meta-Analysis

Anticancer Potential of ACEIs/ARBs Administration in Colorectal Cancer

Author(s): Xin Wang and Haiyun Jing*

Volume 31, Issue 30, 2024

Published on: 16 February, 2024

Page: [4867 - 4879] Pages: 13

DOI: 10.2174/0109298673249782231226101119

Price: $65

Open Access Journals Promotions 2
Abstract

Background: Colorectal cancer (CC) is the fourth most common type of cancer that causes illness and death. Medicines like ACE inhibitors and ARBs, usually used for heart problems, have shown they might help with the growth and development of CC.

Introduction: An analysis of ACE inhibitors and colon cancer is conducted in this comprehensive review. The main goal is to see how ACEIs/ARBs affect the chances of getting cancer and dying in patients with CC.

Methods: A systematic literature search was conducted to identify relevant studies. Inclusion criteria encompassed studies that evaluated the use of ACEIs/ARBs in patients with CC and reported outcomes related to new cancer incidence and mortality. Data from selected studies were extracted and analyzed using appropriate statistical methods.

Results: The study showed that fewer cancer cases occurred in patients who took ACEIs/ARBs compared to those who did not (RR 0.962, 95% CI 0.934-0.991, p = 0.010). Furthermore, patients with CC who utilized ACEIs/ARBs exhibited a decreased mortality rate compared to non-users (HR 0.833, 95% CI 0.640-1.085, p = 0.175).

Conclusion: This review suggests that using ACEIs/ARBs medicine could help people with CC live longer and lower their chances of dying. These results highlight the potential benefits of utilizing ACE inhibitors in the management of CC, warranting further investigation and consideration in clinical practice.

Keywords: ACE inhibitors, colon cancer, mortality, radiotherapy, ACEIs/ARBs therapy, statistical methods.

[1]
Asgharzadeh, F.; Mostafapour, A.; Ebrahimi, S.; Amerizadeh, F.; Sabbaghzadeh, R.; Hassanian, S.M.; Fakhraei, M.; Farshbaf, A.; Ferns, G.A.; Giovannetti, E.; Avan, A.; Khazaei, M. Inhibition of angiotensin pathway via valsartan reduces tumor growth in models of colorectal cancer. Toxicol. Appl. Pharmacol., 2022, 440, 115951.
[http://dx.doi.org/10.1016/j.taap.2022.115951] [PMID: 35235860]
[2]
Asgharzadeh, F.; Naghibzadeh, N.; Hashemzehi, M.; Mostafapour, A.; Hassanian, S.M.; Avan, A.; Khazaei, M. Angiotensin II receptor antagonist, valsartan, has beneficial effect in lung metastasis of colorectal cancer treated with fluorouracil. J. Gastrointest. Cancer, 2023, 54(1), 126-134.
[http://dx.doi.org/10.1007/s12029-021-00717-8] [PMID: 35083728]
[3]
Hashemzehi, M.; Rahmani, F.; Khoshakhlagh, M.; Avan, A.; Asgharzadeh, F.; Barneh, F.; Moradi-Marjaneh, R.; Soleimani, A.; Fiuji, H.; Ferns, G.A.; Ryzhikov, M.; Jafari, M.; Khazaei, M.; Hassanian, S.M. Angiotensin receptor blocker Losartan inhibits tumor growth of colorectal cancer. EXCLI J., 2021, 20, 506-521.
[PMID: 33883980]
[4]
Tabatabai, E.; Khazaei, M.; Asgharzadeh, F.; Nazari, S.E.; Shakour, N.; Fiuji, H.; Ziaeemehr, A.; Mostafapour, A.; Parizadeh, M.R.; Nouri, M.; Hassanian, S.M.; Hadizadeh, F.; Ferns, G.A.; Rahmati, M.; Rahmani, F.; Avan, A. Inhibition of angiotensin II type 1 receptor by candesartan reduces tumor growth and ameliorates fibrosis in colorectal cancer. EXCLI J., 2021, 20, 863-878.
[PMID: 34121975]
[5]
Asgharzadeh, F.; Jafarzadeh-Esfehani, R.; Hassanian, S.M.; Ferns, G.A.; Avan, A.; Khazaei, M. Renin-angiotensin system inhibitors and development of hepatocellular carcinoma: A systematic review and meta-analysis. Curr. Pharm. Des., 2020, 26(39), 5079-5085.
[http://dx.doi.org/10.2174/1381612826666200713165018] [PMID: 32660400]
[6]
Telles-Langdon, S.M.; Arya, V.; Jassal, D.S. Renin angiotensin system (RAS): The common thread between cancer and heart failure, in the renin angiotensin system in cancer, lung. In: Liver and Infectious Diseases; Springer, 2023; pp. 429-449.
[7]
Mostafapour A.; Asgharzadeh F.; Yaghoubi A.; Eskandari M.; Elnaz Nazari S.; Naghibzadeh N.; Baharara J.; Avan A.; Mahdi Hassanian S.; Hajzadeh M. Khazaei M.Angiotensin-converting enzyme inhibitor, enalapril, inhibits tumor growth and potentiates the antitumor efficacy of 5-fu in colorectal cancer. 2022, 9, e2314.
[http://dx.doi.org/10.32113/wcrj_20225_2314]
[8]
Saeedi, N.; Mansoori, S.; Asgharzadeh, F.; Soleimani, A.; Mollazadeh, S.; Hassanian, S.M. Influence of renin-angiotensin system inhibitors on the treatment of metastatic renal cancer. Curr. Pharm. Des., 2023, 29(18), 1459-1465.
[http://dx.doi.org/10.2174/1381612829666230524152108] [PMID: 37226780]
[9]
Salim, H.; Jones, A.M. Angiotensin II receptor blockers (ARBs) and manufacturing contamination: A retrospective National Register Study into suspected associated adverse drug reactions. Br. J. Clin. Pharmacol., 2022, 88(11), 4812-4827.
[http://dx.doi.org/10.1111/bcp.15411] [PMID: 35585835]
[10]
Asgharzadeh, F.; Hassanian, S.M.; Ferns, G.A.; Khazaei, M.; Hasanzadeh, M. The therapeutic potential of angiotensin-converting enzyme and angiotensin receptor inhibitors in the treatment of colorectal cancer: Rational strategies and recent progress. Curr. Pharm. Des., 2019, 24(39), 4652-4658.
[http://dx.doi.org/10.2174/1381612825666190111145140] [PMID: 30636592]
[11]
Wu, J.; Wang, M.; Guo, M.; Du, X. Y.; Tan, X. Z.; Teng, F. Y.; Xu, Y. Angiotensin receptor blocker is associated with a lower fracture risk: An updated systematic review and meta-analysis. Int. J. Clin. Pract., 2022. Wu, J.; Wang, M.; Guo, M.; Du, X. Y.; Tan, X. Z., Teng, F. Y., & Xu, Y. (2022). Angiotensin receptor blocker is associated with a lower fracture risk: An updated systematic review and meta-analysis. Int. J. Clin. Pract., 2022, 2022, 7581110.
[http://dx.doi.org/10.1155/2022/7581110]
[12]
Santiago, T.C.; Parra, L.; Nani, J.V.; Fidalgo, T.M.; Bradshaw, N.J.; Hayashi, M.A.F. Angiotensin-converting enzymes as druggable features of psychiatric and neurodegenerative disorders. J. Neurochem., 2023, 166(2), 138-155.
[http://dx.doi.org/10.1111/jnc.15806] [PMID: 36908214]
[13]
Koh, Sabrina P.; Ethan J.; Kilmister, Agadha C.; Wickremesekera.; Matthew J.; Munro.; Clint Gray.; and Swee T.; Tan. "The Renin-Angiotensin System and Cancer." In The Renin Angiotensin System in Cancer, Lung, Liver and Infectious Diseases. Springer, 2023, 277-339.
[http://dx.doi.org/10.1007/978-3-031-23621-1_15]
[14]
Singh, A.; Bedi, P.M.S. Renin angiotensin system activity in different cancers: Mechanistic insight and preclinical studies. In: The Renin Angiotensin System in Cancer, Lung, Liver and Infectious Diseases; Springer, 2023; pp. 379-394.
[http://dx.doi.org/10.1007/978-3-031-23621-1_18]
[15]
Balkwill, F.; Mantovani, A. Inflammation and cancer: back to Virchow? Lancet, 2001, 357(9255), 539-545.
[http://dx.doi.org/10.1016/S0140-6736(00)04046-0] [PMID: 11229684]
[16]
Valle-Mendiola, A.; Gutiérrez-Hoya, A.; Soto-Cruz, I. JAK/STAT Signaling and cervical cancer: From the cell surface to the nucleus. Genes, 2023, 14(6), 1141.
[http://dx.doi.org/10.3390/genes14061141] [PMID: 37372319]
[17]
Su, J. Renin-Angiotensin System and Cancer: From Laboratory to Clinics; The Renin Angiotensin System in Cancer, Lung, Liver and Infectious Diseases, 2023, pp. 341-363.
[18]
Ivković, I.; Limani, Z.; Jakovčević, A.; Huić, D.; Prgomet, D. Role of matrix metalloproteinases and their inhibitors in locally invasive papillary thyroid cancer. Biomedicines, 2022, 10(12), 3178.
[http://dx.doi.org/10.3390/biomedicines10123178] [PMID: 36551933]
[19]
Pramanik, K.K.; Mishra, R. ERK-mediated upregulation of matrix metalloproteinase-2 promotes the invasiveness in human oral squamous cell carcinoma (OSCC). Exp. Cell Res., 2022, 411(1), 112984.
[http://dx.doi.org/10.1016/j.yexcr.2021.112984] [PMID: 34951997]
[20]
Rao, Q.; Yu, H.; Li, R.; He, B.; Wang, Y.; Guo, X.; Zhao, G.; Wu, F. Dihydroartemisinin inhibits angiogenesis in breast cancer via regulating VEGF and MMP-2/-9. Fundam. Clin. Pharmacol., 2023, fcp.12941.
[http://dx.doi.org/10.1111/fcp.12941] [PMID: 37490927]
[21]
Pinheiro, L.; Perdomo-Pantoja, A.; Casaos, J.; Huq, S.; Paldor, I.; Vigilar, V.; Mangraviti, A.; Wang, Y.; Witham, T.F.; Brem, H.; Tyler, B. Captopril inhibits Matrix Metalloproteinase-2 and extends survival as a temozolomide adjuvant in an intracranial gliosarcoma model. Clin. Neurol. Neurosurg., 2021, 207, 106771.
[http://dx.doi.org/10.1016/j.clineuro.2021.106771] [PMID: 34198223]
[22]
Shebl, R.I. Anticancer potential of captopril and botulinum toxin type-A and associated p53 gene apototic stimulating activity. Iran. J. Pharm. Res., 2019, 18(4), 1967-1977.
[PMID: 32184862]
[23]
Caimi, G.; Hopps, E.; Montana, M.; Urso, C.; Carollo, C.; Canino, B.; Lo Presti, R. The function of matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor (TIMP-1) in several clinical conditions: Results and analysis of our survey. Clin. Hemorheol. Microcirc., 2021, 78(4), 401-416.
[http://dx.doi.org/10.3233/CH-201094] [PMID: 33814420]
[24]
Das, S.; Amin, S.A.; Jha, T. Inhibitors of gelatinases (MMP-2 and MMP-9) for the management of hematological malignancies. Eur. J. Med. Chem., 2021, 223, 113623.
[http://dx.doi.org/10.1016/j.ejmech.2021.113623] [PMID: 34157437]
[25]
Afsar, B.; Afsar, R.E.; Ertuglu, L.A.; Kuwabara, M.; Ortiz, A.; Covic, A.; Kanbay, M. Renin-angiotensin system and cancer: epidemiology, cell signaling, genetics and epigenetics. Clin. Transl. Oncol., 2021, 23(4), 682-696.
[http://dx.doi.org/10.1007/s12094-020-02488-3] [PMID: 32930920]
[26]
Hashemzehi, M.; Beheshti, F.; Hassanian, S.M.; Ferns, G.A.; Khazaei, M.; Avan, A. Therapeutic potential of renin angiotensin system inhibitors in cancer cells metastasis. Pathol. Res. Pract., 2020, 216(7), 153010.
[http://dx.doi.org/10.1016/j.prp.2020.153010] [PMID: 32534713]
[27]
Erdat, E.C.; Koksoy, E.B.; Utkan, G. Enhancing the Anti-angiogenic Effect of Bevacizumab with ACE Inhibition on mCRC. J. Gastrointest. Cancer, 2022, 1-6.
[http://dx.doi.org/10.1007/s12029-022-00890-4] [PMID: 36401084]
[28]
Lu, H.; Yuan, P.; Ma, X.; Jiang, X.; Liu, S.; Ma, C.; Philipsen, S.; Zhang, Q.; Yang, J.; Xu, F.; Zhang, C.; Zhang, Y.; Zhang, W. Angiotensin-converting enzyme inhibitor promotes angiogenesis through Sp1/Sp3-mediated inhibition of notch signaling in male mice. Nat. Comm., 2023, 14, 731.
[http://dx.doi.org/10.1038/s41467-023-36409-z]
[29]
Noureddin, M.; Abdelmalek, M.F. ACE inhibitors: The secret to prevent cirrhosis complications and HCC in NAFLD? Hepatology, 2022, 76(2), 295-297.
[http://dx.doi.org/10.1002/hep.32399] [PMID: 35124826]
[30]
Dierssen-Sotos, T.; Gómez-Acebo, I.; Palazuelos C.; Rodriguez-Moranta, F.; Pérez-Gómez, B.; Fernández Vazquez, J.P.; Amiano P. Relationship between drugs affecting the renin-angiotensin system and colorectal cancer. The MCC-Spain study., 2017, 99, 178-184.
[http://dx.doi.org/10.1016/j.ypmed.2017.01.011]
[31]
Tascilar, K.; Azoulay, L.; Dell’Aniello, S.; Bartels, D.B.; Suissa, S. The use of telmisartan and the incidence of cancer. Am. J. Hypertens., 2016, 29(12), 1358-1365.
[http://dx.doi.org/10.1093/ajh/hpw095]
[32]
Osumi, H.; Matsusaka, S.; Wakatsuki, T.; Suenaga, M.; Shinozaki, E.; Mizunuma, N. Angiotensin II type-1 receptor blockers enhance the effects of bevacizumab-based chemotherapy in metastatic colorectal cancer patients. Mol. Clin. Oncol., 2015, 6(3), 1295-1300.
[http://dx.doi.org/10.3892/mco.2015.630]
[33]
Kedika, R.M.D.; Patel, M.M.D.; Sahdala, P.H.N.M.D.; Mahgoub, A.M.D.; Cipher, D.; Siddiqui, A.A. Long-term use of angiotensin converting enzyme inhibitors is associated with decreased incidence of advanced adenomatous colon. J. Polyps., 2011, 45(2), e12-e16.
[http://dx.doi.org/10.1097/MCG.0b013e3181ea1044]
[34]
Engineer, D.R.; Burney, B.O.; Hayes, T.G.; Garcia, J.M. Exposure to ACEI/ARB and β-blockers is associated with improved survival and decreased tumor progression and hospitalizations in patients with advanced colon cancer. Trans. Oncol., 2013, 6(5), 539-545.
[http://dx.doi.org/10.1593/tlo.13346] [PMID: 24151534]
[35]
Van Der Knaap, R. Renin-angiotensin system inhibitors, angiotensin I-converting enzyme gene insertion/deletion polymorphism, and cancer: The rotterdam study. 2008, 112(4), 748-757.
[http://dx.doi.org/10.1002/cncr.23215] [PMID: 18181094]
[36]
Wang, K.L.; Liu, C.J.; Chao, T.F.; Huang, C.M.; Wu, C.; Chen, T.J.; Chiang, E.N. Long-term use of angiotensin receptor blockers and risk of cancer: A population-based cohort analysis. 2013, 167(5), 2126-2166.
[http://dx.doi.org/10.1016/j.ijcard.2012.05.096]
[37]
Hallas, J.; Rene, C.; Morten, A.; Søren, F.; Lars, B. Long term use of drugs affecting the renin-angiotensin system and the risk of cancer: A population-based case-control study. Br. J. Clin. Pharmacol, 2012, 74(1), 180-188.
[http://dx.doi.org/10.1111/j.1365-2125.2012.04170.x]
[38]
Mansouri, D.; McMillan, D.C.; Roxburgh, C.S.D.; Crighton, E.M.; Horgan, P.G. The impact of aspirin, statins and ACE-inhibitors on the presentation of colorectal neoplasia in a colorectal cancer screening programme. Br. J. Cancer., 2013, 109(1), 249-256.
[http://dx.doi.org/10.1038/bjc.2013.292]
[39]
Cardwell, C.R.; Úna, C.; Menamin, Mc.; Blánaid, M.; Hicks, C.H.; Marie, M.; Cantwell; Liam, J. Drugs affecting the renin-angiotensin system and survival from cancer: A population-based study of breast, colorectal and prostate cancer patient cohorts. BMC Medicine, 2014, 12(1), 1-15.
[http://dx.doi.org/10.1186/1741-7015-12-28]
[40]
Makar, G.A.; Holmes, J.H.; Yang, Y.X. Angiotensin-converting enzyme inhibitor therapy and colorectal cancer risk. J. Natl. Cancer Inst., 2014, 106(2), djt374.
[http://dx.doi.org/10.1093/jnci/djt374]
[41]
Boudreau, D.M.; Koehler, E.; Rulyak, S.J.; Heckbert, S.; Hindorff, R.; Thompson, M.; Mandelson, M. Cardiovascular medication use and risk for colorectal cancer. 2008, 17(11), 3076-3080.
[http://dx.doi.org/10.1158/1055-9965.EPI-08-0095]
[42]
Azoulay, L.; Leone, T.L.; Assimes, H.Y.; Bonnet, D.; Bartels, E.L.; Schiffrin, S.S. Long-term use of angiotensin receptor blockers and the risk of cancer. PloS One, 2012, 7(12), e50893.
[http://dx.doi.org/10.1371/journal.pone.0050893]
[43]
Holmes, S.; Griffith, E.J.; Musto, G.; Minuk, G.Y. Antihypertensive medications and survival in patients with cancer: A population-based retrospective cohort study. Cancer Epidemiol., 2013, 37(6), 881-885.
[http://dx.doi.org/10.1016/j.canep.2013.09.001] [PMID: 24075077]
[44]
Assimes, T.L.; Elstein, E.; Langleben, A.; Suissa, S. Long-term use of antihypertensive drugs and risk of cancer. Pharmacoepidemiol. Drug Saf., 2008, 17(11), 1039-1049.
[http://dx.doi.org/10.1002/pds.1656] [PMID: 18780400]
[45]
McNutt, L.A.; Hafner, J-P.; Xue, X. Correcting the odds ratio in cohort studies of common outcomes. JAMA, 1999, 282(6), 529-529.
[http://dx.doi.org/10.1001/jama.282.6.529] [PMID: 10450713]
[46]
Engineer, D.R.; Burney, B.O.; Hayes, T.G.; Garcia, J.M. Exposure to ACEI/ARB and β-Blockers is associated with improved survival and decreased tumor progression and hospitalizations in patients with advanced colon cancer. Transl. Oncol., 2013, 6(5), 539-545.
[http://dx.doi.org/10.1593/tlo.13346] [PMID: 24151534]
[47]
Terrin, N.; Schmid, C.H.; Lau, J.; Olkin, I. Adjusting for publication bias in the presence of heterogeneity. Stat. Med., 2003, 22(13), 2113-2126.
[http://dx.doi.org/10.1002/sim.1461] [PMID: 12820277]
[48]
Abali, H.; Güllü, I.H.; Engin, H.; Haznedaroğlu, I.C.; Erman, M.; Tekuzman, G. Old antihypertensives as novel antineoplastics: Angiotensin-I-converting enzyme inhibitors and angiotensin II type 1 receptor antagonists. Med. Hypotheses, 2002, 59(3), 344-348.
[http://dx.doi.org/10.1016/S0306-9877(02)00185-8] [PMID: 12208167]
[49]
Almutlaq, M.; Alamro, A.A.; Alamri, H.S.; Alghamdi, A.A.; Barhoumi, T. The effect of local renin angiotensin system in the common types of cancer. Front. Endocrinol., 2021, 12, 736361.
[http://dx.doi.org/10.3389/fendo.2021.736361] [PMID: 34539580]
[50]
Perini, M.V.; Dmello, R.S.; Nero, T.L.; Chand, A.L. Evaluating the benefits of renin-angiotensin system inhibitors as cancer treatments. Pharmacol. Ther., 2020, 211, 107527.
[http://dx.doi.org/10.1016/j.pharmthera.2020.107527] [PMID: 32173557]
[51]
Zhou, Q.; Chen, D.S.; Xin, L.; Zhou, L.Q.; Zhang, H.T.; Liu, L.; Yuan, Y.W.; Li, S.H. The renin–angiotensin system blockers and survival in digestive system malignancies. Medicine (Baltimore), 2020, 99(7), e19075.
[http://dx.doi.org/10.1097/MD.0000000000019075] [PMID: 32049809]
[52]
Li, Y.; Yan, Z.; Chaudhry, K.; Kazlauskas, A. The renin-angiotensin-aldosterone system (RAAS) is one of the effectors by which vascular endothelial growth factor (VEGF)/anti-VEGF controls the endothelial cell barrier. Am. J. Pathol., 2020, 190(9), 1971-1981.
[http://dx.doi.org/10.1016/j.ajpath.2020.06.004] [PMID: 32590003]
[53]
Zhang, H.F.; Gao, X.; Wang, X.; Chen, X.; Huang, Y.; Wang, L.; Xu, Z.W. The mechanisms of renin–angiotensin system in hepatocellular carcinoma: From the perspective of liver fibrosis, HCC cell proliferation, metastasis and angiogenesis, and corresponding protection measures. Biomed. Pharmacother., 2021, 141, 111868.
[http://dx.doi.org/10.1016/j.biopha.2021.111868] [PMID: 34328104]
[54]
Ziaja, M.; Urbanek, K.A.; Kowalska, K.; Piastowska-Ciesielska, A.W. Angiotensin II and angiotensin receptors 1 and 2—multifunctional system in cells biology, what do we know? Cells, 2021, 10(2), 381.
[http://dx.doi.org/10.3390/cells10020381] [PMID: 33673178]
[55]
Pillai U, J.; Ray, A.; Maan, M.; Dutta, M. Repurposing drugs targeting metabolic diseases for cancer therapeutics. Drug Discov. Today, 2023, 28(9), 103684.
[http://dx.doi.org/10.1016/j.drudis.2023.103684] [PMID: 37379903]
[56]
Morris, Z.S.; Saha, S.; Magnuson, W.J.; Morris, B.A.; Borkenhagen, J.F.; Ching, A.; Hirose, G.; McMurry, V.; Francis, D.M.; Harari, P.M.; Chappell, R.; Tsuji, S.; Ritter, M.A. Increased tumor response to neoadjuvant therapy among rectal cancer patients taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Cancer, 2016, 122(16), 2487-2495.
[http://dx.doi.org/10.1002/cncr.30079] [PMID: 27203227]
[57]
Dai, Y.N.; Wang, J.H.; Zhu, J.Z.; Lin, J.Q.; Yu, C.H.; Li, Y.M. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers therapy and colorectal cancer: A systematic review and meta-analysis. Cancer Causes Control, 2015, 26(9), 1245-1255.
[http://dx.doi.org/10.1007/s10552-015-0617-1] [PMID: 26081426]
[58]
Kumekawa, Y. ACEIs/ARBs to improve survival in advanced gastric cancer patients receiving S-1 plus cisplatin. J. Clinical Oncol., 2015, 33(3), 174.
[http://dx.doi.org/10.1200/jco.2015.33.3_suppl.174]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy