Improved outcome with concomitant angiotensin inhibitors

Clinical outcomes may be improved in sunitinib-treated mRCC patients who receive concomitant therapy with an angiotensin inhibitor (ACE inhibitor or angiotensin II receptor inhibitor) (Keizman et al. Eur J Cancer 2011; 47: 1955-1961. www.ncbi.nlm.nih.gov/pubmed/21600760. Preliminary data presented at ASCO 2011 by Kim et al. J Clin Oncol 2011; 29(suppl): e15008).

The retrospective study analysed data from 127 mRCC patients treated with sunitinib 50 mg, 4 weeks on/2 weeks off, during the period 2004-2010. Patients were categorized as an angiotensin inhibitor user or non-user. The two groups were balanced with respect to clinical prognostic factors.

The objective response rate (PR + SD) in angiotensin inhibitor users versus non-users was 86% vs. 72%. The proportion with progressive disease was 14% vs. 28%, respectively. Median PFS was 13 versus 6 months. Median OS was 30 versus 23 months.

It has been speculated that agents that block the angiotensin cascade may have anti-tumour effects. Laboratory studies have reported that angiotensin types 1 and 2 receptors are overexpressed in renal clear-cell carcinoma (Dolley-Hitze et al. Br J Cancer 2010; 103: 1698-1705; www.ncbi.nlm.nih.gov/pubmed/21102591 free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC2994218/pdf/6605866a.pdf).