Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients
Background: Bevacizumab, used in the treatment of metastatic colorectal cancer (mCRC), has an angiogenesis inhibitory effect. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II type 1 receptor blockers (ARBs) used in the treatment of arterial hypertension demonstrate antitumoural eff...
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Shiraz University of Medical Sciences
2025-04-01
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| Series: | Middle East Journal of Cancer |
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| Online Access: | https://mejc.sums.ac.ir/article_50297_afb2a38d11319337faa28ede8ca21b21.pdf |
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| author | Ali Kaan Güren Nargiz Majidova İclal Çakır Nadiye Sever Erkam Kocaaslan Pınar Erel Yeşim Ağyol Abdussamed Çelebi Rukiye Arıkan Selver Işık Murat Sarı Özlem Ercelep İbrahim Vedat Bayoğlu Osman Köstek |
| author_facet | Ali Kaan Güren Nargiz Majidova İclal Çakır Nadiye Sever Erkam Kocaaslan Pınar Erel Yeşim Ağyol Abdussamed Çelebi Rukiye Arıkan Selver Işık Murat Sarı Özlem Ercelep İbrahim Vedat Bayoğlu Osman Köstek |
| author_sort | Ali Kaan Güren |
| collection | DOAJ |
| description | Background: Bevacizumab, used in the treatment of metastatic colorectal cancer (mCRC), has an angiogenesis inhibitory effect. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II type 1 receptor blockers (ARBs) used in the treatment of arterial hypertension demonstrate antitumoural effects through different pathways. In our study, we aimed to investigate whether ACEi or ARB has a synergistic effect on survival in patients receiving bevacizumab treatment.Method: A total of 208 patients receiving Bevacizumab for mCRC were included in this retrospective study. We divided the patients into two groups as Renin Angiotensin System inhibitors (RASi) users and non-users. We compared the progressin-free survival (PFS) and overall survival (OS) times between the 2 groups. Kaplan-Meier and Cox regression analyses were used for statistical analyses.Results: In this study, 53 patients with RASIs and 155 without RASIs were included. The RASIs group had a median PFS of 8.66 months, while the non-RASIs group had a median of 6.67 months (P = 0.034; P < 0.05). The RASIs group had a median OS of 24.86 months, while the non-RASIs group had a 18.71 months (P = 0.039; P < 0.05). In the RASIs group, multivariate analysis showed PFS [hazard ratio (HR): 1.425 (95% confidence interval (CI): 1.037-1.959), P = 0.029] and OS [HR: 1.371 (95% CI: 1.001-1.897), P = 0.044].Conclusion: Bevacizumab in combination with ACEi or ARBs prolongs PFS and OS in patients with mCRC. Prioritising ACEi and ARBs in patients with mCRC and arterial hypertension provides a survival advantage. These findings should be supported through further studies involving larger patient populations and addressing other factors that may affect prognosis. |
| format | Article |
| id | doaj-art-d96310268f00493b8b3e6123c2cb2d9d |
| institution | DOAJ |
| issn | 2008-6709 2008-6687 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Middle East Journal of Cancer |
| spelling | doaj-art-d96310268f00493b8b3e6123c2cb2d9d2025-08-20T03:08:24ZengShiraz University of Medical SciencesMiddle East Journal of Cancer2008-67092008-66872025-04-0116216216910.30476/mejc.2024.102063.207150297Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer PatientsAli Kaan Güren0Nargiz Majidova1İclal Çakır2Nadiye Sever3Erkam Kocaaslan4Pınar Erel5Yeşim Ağyol6Abdussamed Çelebi7Rukiye Arıkan8Selver Işık9Murat Sarı10Özlem Ercelep11İbrahim Vedat Bayoğlu12Osman Köstek13Division of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDepartment of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, TurkeyBackground: Bevacizumab, used in the treatment of metastatic colorectal cancer (mCRC), has an angiogenesis inhibitory effect. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II type 1 receptor blockers (ARBs) used in the treatment of arterial hypertension demonstrate antitumoural effects through different pathways. In our study, we aimed to investigate whether ACEi or ARB has a synergistic effect on survival in patients receiving bevacizumab treatment.Method: A total of 208 patients receiving Bevacizumab for mCRC were included in this retrospective study. We divided the patients into two groups as Renin Angiotensin System inhibitors (RASi) users and non-users. We compared the progressin-free survival (PFS) and overall survival (OS) times between the 2 groups. Kaplan-Meier and Cox regression analyses were used for statistical analyses.Results: In this study, 53 patients with RASIs and 155 without RASIs were included. The RASIs group had a median PFS of 8.66 months, while the non-RASIs group had a median of 6.67 months (P = 0.034; P < 0.05). The RASIs group had a median OS of 24.86 months, while the non-RASIs group had a 18.71 months (P = 0.039; P < 0.05). In the RASIs group, multivariate analysis showed PFS [hazard ratio (HR): 1.425 (95% confidence interval (CI): 1.037-1.959), P = 0.029] and OS [HR: 1.371 (95% CI: 1.001-1.897), P = 0.044].Conclusion: Bevacizumab in combination with ACEi or ARBs prolongs PFS and OS in patients with mCRC. Prioritising ACEi and ARBs in patients with mCRC and arterial hypertension provides a survival advantage. These findings should be supported through further studies involving larger patient populations and addressing other factors that may affect prognosis.https://mejc.sums.ac.ir/article_50297_afb2a38d11319337faa28ede8ca21b21.pdfcolorectal neoplasmsbevacizumabangiotensin-converting enzyme inhibitorsangiotensin ii type 1 receptor blockers |
| spellingShingle | Ali Kaan Güren Nargiz Majidova İclal Çakır Nadiye Sever Erkam Kocaaslan Pınar Erel Yeşim Ağyol Abdussamed Çelebi Rukiye Arıkan Selver Işık Murat Sarı Özlem Ercelep İbrahim Vedat Bayoğlu Osman Köstek Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients Middle East Journal of Cancer colorectal neoplasms bevacizumab angiotensin-converting enzyme inhibitors angiotensin ii type 1 receptor blockers |
| title | Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients |
| title_full | Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients |
| title_fullStr | Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients |
| title_full_unstemmed | Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients |
| title_short | Efficacy of Combined Bevacizumab and Angiotensin-Converting Enzyme Inhibitors or Angiotensin II type 1 Receptor Blockers in Metastatic Colorectal Cancer Patients |
| title_sort | efficacy of combined bevacizumab and angiotensin converting enzyme inhibitors or angiotensin ii type 1 receptor blockers in metastatic colorectal cancer patients |
| topic | colorectal neoplasms bevacizumab angiotensin-converting enzyme inhibitors angiotensin ii type 1 receptor blockers |
| url | https://mejc.sums.ac.ir/article_50297_afb2a38d11319337faa28ede8ca21b21.pdf |
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