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降压药物与胰腺导管腺癌患者生存率之间的相关性

Correlation Between Antihypertensive Drugs and Survival Among Patients with Pancreatic Ductal Adenocarcinoma.

作者信息

Kluz Natalia, Kraj Leszek, Chmiel Paulina, Przybyłkowski Adam M, Wyrwicz Lucjan, Stec Rafał, Szymański Łukasz

机构信息

Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland.

Department of Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland.

出版信息

Cancers (Basel). 2024 Nov 25;16(23):3945. doi: 10.3390/cancers16233945.

Abstract

There is a growing prevalence of pancreatic cancer, accompanied by accelerated disease progression and diminished survival rates. Radical resection with clear margins remains the sole viable option for achieving a long-term cure in patients. In cases of advanced, unresectable, and metastatic disease, chemotherapy based on leucovorin, 5-fluorouracil, irinotecan, oxaliplatin, gemcitabine, or nab-paclitaxel represents the cornerstone of the treatment. Considering the limited treatment options available following initial therapy, the strategy of repurposing commonly prescribed drugs such as antihypertensives into anti-cancer therapies in palliative treatment represents a promising avenue for enhancing survival in patients with pancreatic ductal adenocarcinoma. The repurposing of existing drugs is typically a more cost-effective and expedient strategy than the development of new ones. The potential for antihypertensive drugs to be employed as adjunctive therapies could facilitate a more comprehensive treatment approach by targeting multiple pathways involved in cancer progression and acquired resistance to treatment. Antihypertensive medications, particularly those belonging to the pharmacological classes of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers, are commonly prescribed and have well-established safety profiles, particularly among patients with pancreatic cancer who are affected by multiple comorbidities. Therefore, we emphasize the preclinical and clinical evidence supporting the use of antihypertensive agents in the treatment of pancreatic cancer, emphasizing their beneficial chemosensitizing effects.

摘要

胰腺癌的患病率日益上升,同时疾病进展加速,生存率降低。切缘阴性的根治性切除术仍然是患者实现长期治愈的唯一可行选择。对于晚期、不可切除和转移性疾病,基于亚叶酸、5-氟尿嘧啶、伊立替康、奥沙利铂、吉西他滨或纳米白蛋白结合型紫杉醇的化疗是治疗的基石。鉴于初始治疗后可用的治疗选择有限,将常用药物(如抗高血压药)重新用于胰腺癌姑息治疗中的抗癌疗法,是提高胰腺导管腺癌患者生存率的一个有前景的途径。与开发新药相比,现有药物的重新利用通常是一种更具成本效益且更便捷的策略。抗高血压药物作为辅助疗法的潜力,可以通过针对癌症进展和获得性治疗耐药性所涉及的多种途径,促进更全面的治疗方法。抗高血压药物,特别是那些属于血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂和钙通道阻滞剂药理学类别的药物,是常用药物,并且具有公认的安全性,特别是在受多种合并症影响的胰腺癌患者中。因此,我们强调支持使用抗高血压药物治疗胰腺癌的临床前和临床证据,强调其有益的化学增敏作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eddd/11640600/88e65bc97af4/cancers-16-03945-g001.jpg

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