Evidence mapPaperPMID 39340700Full record

ArticleJournal of cancer research and clinical oncology2024

Synergistic effects of calcium channel blockers and renin-angiotensin inhibitors with gemcitabine-based chemotherapy on the survival of patients with pancreatic cancer.

Leszek Kraj, Paulina Chmiel, Andrzej Śliwczyński, Łukasz Szymański, Krzysztof Woźniak, Maciej Słodkowski, Tomasz Stokłosa, Lucjan Wyrwicz

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Article in Journal of cancer research and clinical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Leszek KrajDepartment of Oncology, Medical University of Warsaw, 02-091, Warsaw, Poland. leszek.kraj@wum.edu.pl.
Paulina ChmielDepartment of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, 05-552, Garbatka, Poland.
Andrzej ŚliwczyńskiNational Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland.
Łukasz SzymańskiDepartment of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, 05-552, Garbatka, Poland.
Krzysztof WoźniakDepartment of Oncology, Medical University of Warsaw, 02-091, Warsaw, Poland.
Maciej SłodkowskiDepartment of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, 02097, Warsaw, Poland.
Tomasz StokłosaDepartment of Tumor Biology, Genetics Medical University of Warsaw, Warsaw, Poland.
Lucjan WyrwiczDepartment of Oncology, Radiotherapy Maria Sklodowska-Curie National Cancer Research Institute, Warsaw, Poland.

Funding

Ministerstwo Edukacji i Nauki FS200/1WP/LK/1
6 · The paper itself

Abstract

purposePancreatic cancer remains a significant public health challenge, with poor long-term outcomes due to the lack of effective treatment options. Repurposing commonly used clinical drugs, such as ACE inhibitors, ARBs, CCBs, and metformin, may enhance the efficacy of chemotherapy and offer a promising therapeutic strategy for improving patient outcomes.

methodsA retrospective analysis of concomitant treatment with ACE-Is, ARBs, CCBs, and metformin alongside gemcitabine chemotherapy in patients with pancreatic cancer was conducted. Treatment responses were evaluated, with overall survival (OS) estimated using the Kaplan-Meier method. Additionally, the Cox proportional hazards model was employed to assess the impact of these specific agents on patient survival.

results4628 patients with various stages of pancreatic cancer were identified in the database between 2007 and 2016. The estimated overall survival (OS) in the analyzed group was 6.9 months (95% CI 6.4-7). The use of any of the analyzed drugs was associated with a significant improvement in mOS of 7.5 months (95% CI 6.8-7.8) vs. 6.7 months (95% CI 6.4-7.0) for patients who did not have additional treatment (p < 0.0001). ARBs, ACE-Is, CCBs, and metformin varied in their effectiveness in prolonging mOS among patients. The longest mOS of 8.9 months (95% CI 7.7-11.6) was observed in patients receiving additional therapy with ARBs, while the shortest mOS of 7.7 months (95% CI 6.5-8.9) was achieved by patients receiving metformin. In the adjusted Cox analysis, metformin was associated with a significantly weaker effect on mOS (p = 0.029). A particularly interesting trend in prolonging 5-year survival was demonstrated by ARBs and CCBs with 14.1% (95% CI 9-22%) and 14.8% (95% CI 11.1-19.6%), respectively, compared to patients not taking these drugs, who achieved a 5-year OS of 3.8% (95% CI 3.2-4.4%).

conclusionOur results demonstrate a significant positive impact of ARBs, ACE inhibitors, and CCBs on survival in patients with pancreatic cancer treated with gemcitabine. The addition of these inexpensive and relatively safe drugs in patients with additional comorbidities may represent a potential therapeutic option in this indication. However, prospective clinical trials to evaluate the optimal patient population and further studies to determine the potential impact of these agents on chemotherapy are necessary.

Indexed as

Angiotensin Receptor AntagonistsAntineoplastic Combined Chemotherapy ProtocolsCalcium Channel BlockersDeoxycytidineGemcitabinePancreatic NeoplasmsAdultAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsDrug SynergismFemaleHumansMaleMetforminMiddle AgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCalcium Channel BlockersDeoxycytidineGemcitabineMetforminAngiotensin inhibitorsBackgroundCalcium channel blockersDrug repurposingOverall survivalPancreatic cancer

Identifiers

PMID39340700
PMCPMC11438632

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.