Key result
Current evidence is inadequate to establish a causal relationship between RAAS blocker use and the development of lung cancer, and there is no need to change clinical practice.
Why the study?
Concerns have emerged regarding a possible link between RAAS-blockers and an increased risk of cancer, especially lung cancer, but pharmaco-epidemiologic studies have reported inconsistent findings.
Does RAAS blockade increase the risk of developing de novo lung cancer?
Does RAAS blockade increase the risk of developing de novo lung cancer?
This review confirms that there is currently no evidence linking RAAS blockers to an increased risk of lung cancer, supporting their continued use in clinical practice without modification.
Answers are grounded in this paper and cite their sources.
Supports RAAS blockade safety in observational data; leaves open prospective confirmation in oncology settings.
PURPOSE: The blockade of the renin-angiotensin-aldosterone system (RAAS) by angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) is one of the most common treatments for hypertension, heart failure and renal diseases. However, concerns have been raised about a possible link between RAAS-blockers and an increased risk of cancer, particularly of lung cancer. This narrative review aims to give a critical appraisal of current evidence and to help physicians understand potential links between RAAS blockade and de novo lung cancer development. METHODS: Numerous pharmaco-epidemiologic studies, mostly retrospective cohort analyses, evaluated the association of RAAS blockade with lung cancer incidence and reported inconsistent findings. Meta-analyses could not further clarify a possible link between RAAS blockade and the risk of lung cancer. RESULTS: International regulatory agencies (FDA, EMA) have concluded that the use of RAAS blockers is not associated with an increased risk of developing lung cancer. Co-administration of RAAS blockers to systemic therapy of advanced non-small cell lung cancer seems to have positive effects on the outcome. CONCLUSION: Until more comprehensive analyses have been completed, there is no need to change clinical practise. Additional prospective randomized trials with long-term follow-up are needed to investigate the effects of these drugs on the development and progression of lung cancer.
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Rachow et al. (2020) conducted a review in Lung cancer. Renin-angiotensin-aldosterone system (RAAS) blockers vs. Non-users or other antihypertensive drugs was evaluated on Lung cancer incidence. Current evidence is inadequate to establish a causal relationship between RAAS blocker use and the development of lung cancer, and there is no need to change clinical practice.
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