Key result
Concomitant use of ACEIs/ARBs in patients with pancreatic ductal adenocarcinoma was associated with improved 12-month event-free survival (22.86% vs 13.69%; HR 0.71; 95% CI 0.52-0.96; p=0.024).
Why the study?
The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma necessitates the exploration of novel strategies to overcome treatment resistance.
Does the concomitant use of ACEIs/ARBs improve survival outcomes in patients with pancreatic ductal adenocarcinoma?
Cohort (n=384)
No
Does the concomitant use of ACEIs/ARBs improve survival outcomes in patients with pancreatic ductal adenocarcinoma?
Hazard Ratio: 0.71 (95% CI 0.52–0.96)
Absolute Event Rate: 22.86% vs 13.69%
p-value: p=0.024
Concomitant use of ACEIs or ARBs in patients with pancreatic ductal adenocarcinoma is associated with significantly better 12-month event-free survival.
RAS blocker use was associated with better 12-month EFS in PDAC; leaves open survival benefit and should not yet change practice.
Background: The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma (PDAC) necessitates the exploration of novel strategies to overcome treatment resistance. Objectives: This study aimed to investigate the impact of combining renin–angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC. Design: Patients with PDAC were enrolled in the retrospective study. Methods: We analyzed patients with PDAC ( n = 384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers. Results: Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p = 0.008) compared to the non-ACEI/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI/ARB was associated with better 12-month EFS (hazards ratio = 0.71, 95% confidence interval: 0.52–0.96; p = 0.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes. Conclusion: Concomitant use of ACEIs/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.
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Tseng et al. (2024) conducted a cohort in Pancreatic ductal adenocarcinoma (PDAC) (n=384). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) vs. Non-ACEI/ARB group was evaluated on 12-month event-free survival (EFS) (HR 0.71, 95% CI 0.52-0.96, p=0.024). Concomitant use of ACEIs/ARBs in patients with pancreatic ductal adenocarcinoma was associated with improved 12-month event-free survival (22.86% vs 13.69%; HR 0.71; 95% CI 0.52-0.96; p=0.024).
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