Survival Analysis of 1140 Patients with Biliary Cancer and Benefit from Concurrent Renin-Angiotensin Antagonists, Statins, or Aspirin with Systemic Therapy

Gunchick, Valerie; McDevitt, Rachel L; Choi, Elizabeth; Winslow, Katherine; Zalupski, Mark M.; Sahai, Vaibhav

doi:10.1093/oncolo/oyad063

Cited by 4 publications

(2 citation statements)

References 90 publications

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“…This may due to a lower incidence of CCA compared with other cancers, including breast cancer and gastrointestinal cancer. Several studies explored the impact of RASis on patients with advanced, or recurrent, and/or metastatic CCA but got negative results [ 47 , 48 ]. Herein, we described a PS matching cohort of 84 CCA patients and demonstrated that RASis usage could improve the survival of CCA patients.…”

Section: Discussionmentioning

confidence: 99%

Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: a propensity score-matched cohort study

Zhu,

Li,

Fang

et al. 2023

BMC Cancer

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Background Hypertension is a risk factor for cholangiocarcinoma (CCA). The effect of anti-hypertensive drugs on the prognosis of CCA is not clear. Methods This is a retrospective study of 102 patients (56.9% males, median age 66 years) diagnosed with CCA and hypertension concurrently and received radical surgery (R0), with a median follow-up of 36.7 months. Kaplan-Meier analysis, Cox regressions, and propensity score (PS) matching were applied for statistical analysis. Results Results of multivariable cox analysis showed that renin-angiotensin system inhibitors (RASis) usage was a protective factor for progression-free survival (PFS) (hazard ratio [HR] = 0.55, 95% confidence interval [95% CI]: 0.32–0.96) and overall survival (OS) (HR = 0.40, 95% CI: 0.20–0.79), respectively. Calcium channel blockers, diuretics, and β-blockers didn’t show significant associations. The association of RASis usage and PFS and OS was derived by PS matching, with a cohort of 28 RASis users and 56 RASis non-users. The median PFS and OS of RASis users (PFS, 17.6 months (9.2–34.4); OS, 24.8 months (16.5–42.3)) were longer than RASis non-users (PFS, 10.5 months (4.1–24.1); OS, 14.6 months (10.6–28.4)). The 1 year, 2 years, and 3 years’ survival rates of RASis users (89.1%, 77.0%, and 65.5%) were higher than RASis non-users (70.9%, 54.0%, and 40.0%). Conclusions RASis usage improves the survival of patients with CCA and hypertension concurrently.

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Section: Discussionmentioning

confidence: 99%

Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: a propensity score-matched cohort study

Zhu,

Li,

Fang

et al. 2023

BMC Cancer

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“…Lastly, a recently published study that included 1140 biliary cancer patients evaluated the benefit of concurrent statins with systemic therapy. Patients who received concomitant statins with systemic therapy versus those who received only systemic therapy did not experience improved progression-free (5.5 vs. 5.5 months; hazard ratio (HR) 1.1; p = 0.51) or overall survival (12.3 vs. 12.6 months; HR 1.1; p = 0.18), respectively [159].…”

Section: Statins In Cca Treatmentmentioning

confidence: 92%

Don’t Judge a Book by Its Cover: The Role of Statins in Liver Cancer

Piekuś-Słomka,

Mocan,

Shkreli

et al. 2023

Cancers

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Statins, which are inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, are an effective pharmacological tool for lowering blood cholesterol levels. This property makes statins one of the most popular drugs used primarily to prevent cardiovascular diseases, where hyperlipidemia is a significant risk factor that increases mortality. Nevertheless, studies conducted mainly in the last decade have shown that statins might prevent and treat liver cancer, one of the leading causes of cancer-related mortality worldwide. This narrative review summarizes the scientific achievements to date regarding the role of statins in liver tumors. Molecular biology tools have revealed that cell growth and proliferation can be inhibited by statins, which further inhibit angiogenesis. Clinical studies, supported by meta-analysis, confirm that statins are highly effective in preventing and treating hepatocellular carcinoma and cholangiocarcinoma. However, this effect may depend on the statin’s type and dose, and more clinical trials are required to evaluate clinical effects. Moreover, their potential hepatotoxicity is a significant caveat for using statins in clinical practice. Nevertheless, this group of drugs, initially developed to prevent cardiovascular diseases, is now a key candidate in hepato-oncology patient management. The description of new drug-statin-like structures, e.g., with low toxicity to liver cells, may bring another clinically significant improvement to current cancer therapies.

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Dietary intake, obesity, and physical activity in association with biliary tract cancer risk: Results from meta‐analyses of individual‐level data from prospective cohort studies of 723,326 adults

Gunchick,

Wen,

Jia

et al. 2024

Intl Journal of Cancer

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Biliary tract cancer (BTC) is a rare and aggressive malignancy with increasing incidence. Most BTC cases are diagnosed with metastatic disease which carries a 5‐year survival rate of <5%. Physical activity, diet, and obesity might be associated with BTC risk, but studies have been limited particularly in African descendants. We addressed this knowledge gap by evaluating associations of BTC risk with obesity, physical activity, and dietary intakes in 723,326 adult participants in four cohort studies conducted in China, the United Kingdom, and the United States. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) in each cohort; results were combined using meta‐analysis. All cohorts had ≥11 median follow‐up years with 839 incident BTC cases combined. BTC risk was positively associated with body mass index (BMI) and waist‐to‐hip ratio (WHR) whereas physical activity, fruit intake, and fish intake were inversely associated. HR and (95% CI) comparing BMI >35.0 to 18.5–24.9: 1.71 (1.26, 2.31), p‐trend <.0001; comparing BMI‐adjusted WHR top to bottom quartile: 1.20 (0.94, 1.53), p‐trend = .05; comparing ≥15–0 metabolic equivalent task‐hours/week 0.76 (0.61, 0.94), p‐trend = .009; comparing highest to lowest intake tertile for fruit and fish 0.79 (0.66, 0.95), p‐trend = .01; 0.82 (0.68, 0.98), p‐trend = .04, respectively. Associations were, in general, similar across ancestry groups. Our study provides strong evidence for important roles of obesity, diet, and physical activity in BTC etiology and stresses the need for lifestyle modification to combat the rising incidence of this fatal malignancy.

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Survival Analysis of 1140 Patients with Biliary Cancer and Benefit from Concurrent Renin-Angiotensin Antagonists, Statins, or Aspirin with Systemic Therapy

Cited by 4 publications

References 90 publications

Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: a propensity score-matched cohort study

Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: a propensity score-matched cohort study

Don’t Judge a Book by Its Cover: The Role of Statins in Liver Cancer

Dietary intake, obesity, and physical activity in association with biliary tract cancer risk: Results from meta‐analyses of individual‐level data from prospective cohort studies of 723,326 adults

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