Yu Junjie, Meng Fangang, Sui Wenxia, Yu Junmin, Shen Jinhai
Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Pain Treatment, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Front Pharmacol. 2024 Jun 4;15:1378577. doi: 10.3389/fphar.2024.1378577. eCollection 2024.
The impact of renin-angiotensin system inhibitors (RASIs) on the outcome of hypertensive cancer patients undergoing immune checkpoint inhibitor (ICIs) therapy remains ambiguous. This investigation sought to elucidate the consequences of RASIs use on the prognosis for this specific patient group within the context of ICIs treatment, aspiring to provide a clearer basis for rational, evidence-driven choices in the clinical prescription of these medications.
A comprehensive search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library for original studies published up to 6 August 2023. Studies published in English reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and/or progression-free survival (PFS) were included. All statistical analyses were executed utilizing R software (version 4.2.2).
A total of 13 studies, encompassing approximately 12,595 patients, satisfied the inclusion criteria. Meta-analyses demonstrated a statistically significant association between the use of RASIs and a favorable outcome in OS (HR, 0.74; 95% CI, 0.62-0.88) and PFS (HR, 0.77; 95% CI, 0.62-0.96) among cancer patients receiving ICIs treatment.
This investigation provides compelling evidence supporting the beneficial prognostic impact of RASIs on cancer patients receiving ICIs. RASIs present a viable option as antihypertensive agents for cancer patients with hypertension undergoing ICIs treatment. Further exploration and validation through prospective studies are necessary to establish definitive guidelines for the use of RASIs in managing hypertensive cancer patients undergoing immunotherapy with ICIs.
https://www.crd.york.ac.uk/prospero/, identifier CRD42023454886.
肾素-血管紧张素系统抑制剂（RASIs）对接受免疫检查点抑制剂（ICIs）治疗的高血压癌症患者结局的影响仍不明确。本研究旨在阐明在ICIs治疗背景下使用RASIs对这一特定患者群体预后的影响，以期为这些药物的临床处方中合理、循证决策提供更清晰的依据。
在PubMed、Embase、Web of Science和Cochrane图书馆全面检索截至2023年8月6日发表的原始研究。纳入以英文发表的报告总体生存（OS）和/或无进展生存（PFS）的风险比（HRs）及95%置信区间（CIs）的研究。所有统计分析均使用R软件（版本4.2.2）进行。
共有13项研究，涵盖约12,595例患者，符合纳入标准。荟萃分析表明，在接受ICIs治疗的癌症患者中，使用RASIs与OS（HR，0.74；95%CI，0.62 - 0.88）和PFS（HR，0.77；95%CI，0.62 - 0.96）的良好结局之间存在统计学显著关联。
本研究提供了有力证据，支持RASIs对接受ICIs治疗的癌症患者具有有益的预后影响。对于接受ICIs治疗的高血压癌症患者，RASIs作为抗高血压药物是一种可行的选择。有必要通过前瞻性研究进一步探索和验证，以建立在管理接受ICIs免疫治疗的高血压癌症患者中使用RASIs的明确指南。
