Document Type : Original Article(s)
Authors
- Ali Kaan Güren 1
- Nargiz Majidova 1
- İclal Çakır 2
- Nadiye Sever 1
- Erkam Kocaaslan 1
- Pınar Erel 1
- Yeşim Ağyol 1
- Abdussamed Çelebi 1
- Rukiye Arıkan 1
- Selver Işık 1
- Murat Sarı 1
- Özlem Ercelep 1
- İbrahim Vedat Bayoğlu 1
- Osman Köstek 1
1 Division of Medical Oncology, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
2 Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
Abstract
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.
Highlights
Ali Kaan Güren (Google Scholar)
Keywords
- Colorectal neoplasms
- Bevacizumab
- Angiotensin-converting enzyme inhibitors
- Angiotensin II type 1 receptor blockers
Main Subjects
How to cite this article:
Güren AK, Majidova N, Çakır İ, Sever N, Kocaaslan E, Erel P, et al. Efficacy of combined Bevacizumab and angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor blockers in metastatic colorectal cancer patients. Middle East J Cancer. 2025;16(2):162-9. doi: 10.30476/mejc.2024.102063.2071.
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