Blood-pressure drugs could improve colorectal cancer survival, study
suggests

Date:
August 19, 2021
Source:
University of Virginia Health System
Summary:
ACE inhibitors, beta-blockers and thiazide diuretics were all
associated with decreased mortality in patients with colorectal
cancer.



FULL STORY ========================================================================== Common blood-pressure drugs may improve survival for patients with
colorectal cancer, a new study suggests.


========================================================================== After reviewing outcomes of almost 14,000 patients with colorectal cancer, researchers determined that ACE inhibitors, beta-blockers and thiazide diuretics were all associated with decreased mortality. They also found
that patients who took their blood-pressure drugs consistently were less
likely to die from their cancer.

The researchers emphasize that more research is needed to validate the connection between blood-pressure drugs and better outcomes. But they
say they are hopeful that the drugs could offer a new, low-cost way to
improve care for patients with stage I-III colorectal cancer.

"Cost-effective solutions to prolong cancer survivorship in older patients
may lie in commonly used medications," said researcher Rajesh Balkrishnan,
PhD, of the University of Virginia School of Medicine's Department
of Public Health Sciences. "However, we need further confirmation
of these findings through clinical trials." About Colorectal Cancer
Colorectal cancer is the third most commonly diagnosed cancer in the
United States. The American Cancer Society estimates that this year
there will be 104,270 new cases of colon cancer and 45,230 cases of
rectal cancer in the U.S.

A troubling rise in the number of younger people developing colorectal
cancer recently prompted the U.S. Preventive Services Task Force to
reduce the recommended age for first screening for the disease to 45
from 50. (Colon cancer killed beloved "Black Panther" star Chadwick
Boseman last year, when he was only 43.) High blood pressure is
common among patients with colorectal cancer, but there has been little research into the potential effect of blood-pressure drugs on patients' outcomes. Researchers at UVA Cancer Center and the Universidade de Sa~o
Paulo Instituto do Ca^ncer do Estado de Sa~o Paulo wanted to change
that, so they conducted a large retrospective analysis. They used the Surveillance, Epidemiology, and End-Results (SEER) Medicare database to
review outcomes of 13,982 patients ages 65 and older who were diagnosed
with colorectal cancer between Jan. 1, 2007, and Dec. 31, 2012.



==========================================================================
The researchers found that ACE inhibitors and thiazide diuretics appeared
to provide the most significant benefit to patient survival and outcomes,
while there did not appear to be similar benefits from calcium-channel blockers.

Patients' adherence to their blood-pressure regimen also appears
important: "Our results show an association between increased adherence
to [blood- pressure] medications and reduced ... mortality in patients
starting these medications after stage I, II or III CRC diagnosis relative
to those who did not," the researchers write in a new scientific paper outlining their findings.

"Although further analysis is necessary, this increment of survival may
be associated with a higher dose exposure, as a long-term/high-dose
exposure to ACE-Is/ARBs was associated with a decreased incidence of
CRC mortality." The scientists are uncertain if the apparent benefits
from the blood-pressure drugs stem from the drugs themselves or from controlling patients' high blood pressure. They can envision scenarios
that support either option -- or both.

The researchers note that there have been several recent clinical
trials testing blood-pressure drugs' potential usefulness against other cancers. More research is warranted into the drugs' application for
colorectal cancer, as well as their potential benefits in gastric and
bladder cancer, they conclude.

"It is heartening to note that we could confirm the results of the
animal model work done by Dr. Roger Chammas and colleagues at the
University of Sa~o Paulo Cancer Center in a human population as well," Balkrishnan said. "We will continue to explore these protective effects
of antihypertensives on other cancers as well in human populations using stronger study designs. This could potentially provide significant
implications for gastrointestinal cancer treatment." The work was
supported by UVA Cancer Center and Fundac,a~o de Amparo a` Pesquisa do
Estado de Sa~o Paulo.

========================================================================== Story Source: Materials provided by
University_of_Virginia_Health_System. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Rajesh Balkrishnan, Raj P. Desai, Aditya Narayan, Fabian T. Camacho,
Lucas E. Flausino, Roger Chammas. Associations between initiating
antihypertensive regimens on stage I-III colorectal cancer outcomes:
A Medicare SEER cohort analysis. Cancer Medicine, 2021; 10 (15):
5347 DOI: 10.1002/cam4.4088 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/08/210819113037.htm

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