The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Eur J Cancer. 2011 Sep;47(13):1955-61. doi: 10.1016/j.ejca.2011.04.019. Epub 2011 May 18.
Sunitinib is a standard treatment for metastatic renal cell carcinoma. Angiotensin system inhibitors, including angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, are widely used in hypertension, kidney disease and heart failure. Data suggests that they may inhibit tumourigenesis.
To study the effect of angiotensin system inhibitors on sunitinib treatment outcome in metastatic renal cell carcinoma.
We performed a retrospective study of an unselected cohort of patients with metastatic renal cell carcinoma who were treated with sunitinib. Patients were divided into angiotensin system inhibitors users (group 1) and non-users (group 2). The effect of angiotensin system inhibitors on objective response, time to disease progression and overall survival, was tested with adjustment for known confounding risk factors through logistic regression model and Cox regression model.
Between 2004 and 2010, 127 patients with metastatic renal cell carcinoma were treated with sunitinib, 44 group 1 and 83 group 2. The groups were balanced regarding known clinicopathologic prognostic factors. Objective response was partial response/stable disease 86% versus 72% and progressive disease 14% versus 28% (p=0.07) in group 1 versus 2, respectively. Median progression free survival was 13 versus 6 months (HR 0.537, p=0.0055), and median overall survival 30 versus 23 months (HR 0.688, p=0.21), in favour of group 1.
Angiotensin system inhibitors may improve the outcome of sunitinib treatment in metastatic renal cell carcinoma. This should be investigated prospectively, and if validated applied in clinical practise and clinical trials.
舒尼替尼是转移性肾细胞癌的标准治疗方法。血管紧张素系统抑制剂，包括血管紧张素转换酶抑制剂和血管紧张素 II 受体阻滞剂，广泛用于高血压、肾病和心力衰竭。有数据表明它们可能抑制肿瘤发生。
研究血管紧张素系统抑制剂对转移性肾细胞癌舒尼替尼治疗结果的影响。
我们对接受舒尼替尼治疗的转移性肾细胞癌未选择患者进行了回顾性研究。患者分为血管紧张素系统抑制剂使用者（第 1 组）和非使用者（第 2 组）。通过逻辑回归模型和 Cox 回归模型，调整已知混杂风险因素，检验血管紧张素系统抑制剂对客观缓解、疾病进展时间和总生存期的影响。
2004 年至 2010 年间，127 例转移性肾细胞癌患者接受了舒尼替尼治疗，其中 44 例为第 1 组，83 例为第 2 组。两组在已知的临床病理预后因素方面平衡。第 1 组的客观缓解率为部分缓解/稳定疾病 86%，而第 2 组为 72%；疾病进展率分别为 14%和 28%（p=0.07）。第 1 组无进展生存期中位数为 13 个月，而第 2 组为 6 个月（HR 0.537，p=0.0055）；第 1 组总生存期中位数为 30 个月，而第 2 组为 23 个月（HR 0.688，p=0.21）。
血管紧张素系统抑制剂可能改善转移性肾细胞癌患者舒尼替尼治疗的结局。这需要前瞻性研究，如果得到验证，可应用于临床实践和临床试验。
