Jang Ha Young, Kim In-Wha, Oh Jung Mi
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea.
Front Oncol. 2022 Apr 7;12:858855. doi: 10.3389/fonc.2022.858855. eCollection 2022.
Cysteinyl leukotrienes receptor antagonists (LTRAs) are promising chemoprevention options to target cysteinyl leukotriene signaling in cancer. However, only a number of randomized clinical trials (RCTs) or observational studies have been conducted to date; thus, the effect of LTRAs on patients is yet to be elucidated. Using insurance claim data, we aimed to evaluate whether LTRAs have cancer preventive effects by observing patients who took LTRAs.
Patients diagnosed with asthma, allergic rhinitis, chronic cough, and have no history of cancer were followed-up from 2005 to 2017. Cox proportional hazard regression analysis was conducted to estimate the hazard ratios (HRs) for cancer risk of LTRA users.
We followed-up (median: 5.6 years) 188,906 matched patients (94,453 LTRA users and 94,453 non-users). LTRA use was associated with a decreased risk of cancer (adjusted HR [aHR] = 0.85, 95% confidence interval [CI] = 0.83-0.87). The cancer risk showed a tendency to decrease rapidly when LTRAs were used in high dose (aHR = 0.56, 95% CI = 0.40-0.79) or for longer durations of more than 3 years (aHR = 0.68, 95% CI = 0.60-0.76) and 5 years (aHR = 0.33, 95% CI = 0.26-0.42). The greater preventive effects of LTRAs were also observed in patients with specific risk factors related to sex, age, smoking, and the presence of comorbidities.
In this study, we found that LTRA use was associated with a decreased risk of cancer. The high dose and long duration of the use of LTRAs correlated with a lower cancer risk. Since LTRAs are not yet used for the prevention or treatment of cancer, our findings could be used for developing a new chemo-regimen or designing feasible RCTs.
半胱氨酰白三烯受体拮抗剂（LTRA）是针对癌症中半胱氨酰白三烯信号传导的有前景的化学预防选择。然而，迄今为止仅进行了一些随机临床试验（RCT）或观察性研究；因此，LTRA对患者的影响尚待阐明。利用保险理赔数据，我们旨在通过观察服用LTRA的患者来评估LTRA是否具有癌症预防作用。
对2005年至2017年期间诊断为哮喘、过敏性鼻炎、慢性咳嗽且无癌症病史的患者进行随访。进行Cox比例风险回归分析以估计LTRA使用者患癌风险的风险比（HR）。
我们对188,906名匹配患者（94,453名LTRA使用者和94,453名非使用者）进行了随访（中位时间：5.6年）。使用LTRA与患癌风险降低相关（调整后HR [aHR] = 0.85，95%置信区间 [CI] = 0.83 - 0.87）。当高剂量使用LTRA（aHR = 0.56，95% CI = 0.40 - 0.79）或使用超过3年（aHR = 0.68，95% CI = 0.60 - 0.76）以及5年（aHR = 0.33，95% CI = 0.26 - 0.42）时，癌症风险呈现迅速下降的趋势。在具有与性别、年龄、吸烟和合并症相关的特定风险因素的患者中也观察到LTRA具有更大的预防效果。
在本研究中，我们发现使用LTRA与患癌风险降低相关。LTRA的高剂量和长期使用与较低的癌症风险相关。由于LTRA尚未用于癌症的预防或治疗，我们的研究结果可用于开发新的化疗方案或设计可行的RCT。
