51
|
Sun H, Li T, Zhuang R, Cai W, Zheng Y. Do renin-angiotensin system inhibitors influence the recurrence, metastasis, and survival in cancer patients?: Evidence from a meta-analysis including 55 studies. Medicine (Baltimore) 2017; 96:e6394. [PMID: 28353566 PMCID: PMC5380250 DOI: 10.1097/md.0000000000006394] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Renin-angiotensin system inhibitors (RAS inhibitors) are antihypertensive agents with potential antitumor effects. However, various studies have yielded conflicting results on the influence of RAS inhibitors on survival of cancer patients. The aim of this study was to evaluate the effect of RAS inhibitors on recurrence, metastasis, and survival in cancer patients through a meta-analysis. METHODS PubMed, Web of Science, EMBASE, and Cochrane Library were systematically searched from inception to December 2016. The pooled hazard ratio (HR) with its 95% confidence interval (95% CI) was calculated to evaluate the association between RAS inhibitors and recurrence, metastasis, and survival in cancer patients. RESULTS Fifty-five eligible studies were included in the present meta-analysis. Results showed that there were significant improvements in overall survival (OS) (HR = 0.82; 95% CI: 0.77-0.88; P < 0.001), progression-free survival (HR = 0.74; 95% CI: 0.66-0.84; P < 0.001), and disease-free survival (HR = 0.80; 95% CI: 0.67-0.95; P = 0.01) in RAS inhibitor users compared with nonusers. Subgroup analyses revealed that the effect of RAS inhibitors on OS depended on the cancer type or different RAS inhibitors. CONCLUSION This meta-analysis suggests that RAS inhibitors could improve the survival of cancer patients and depend on cancer type and types of RAS inhibitors.
Collapse
Affiliation(s)
- Hong Sun
- Department of Clinical Pharmacy, School of Pharmacy
| | - Tao Li
- Department of Clinical Pharmacy, School of Pharmacy
| | | | - Weimin Cai
- Department of Clinical Pharmacy, School of Pharmacy
| | - Yuanting Zheng
- State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China
| |
Collapse
|
52
|
Dethlefsen C, Pedersen KS, Hojman P. Every exercise bout matters: linking systemic exercise responses to breast cancer control. Breast Cancer Res Treat 2017; 162:399-408. [PMID: 28138894 DOI: 10.1007/s10549-017-4129-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/20/2017] [Indexed: 12/27/2022]
Abstract
Cumulative epidemiological evidence shows that regular exercise lowers the risk of developing breast cancer and decreases the risk of disease recurrence. The causality underlying this relation has not been fully established, and the exercise recommendations for breast cancer patients follow the general physical activity guidelines, prescribing 150 min of exercise per week. Thus, elucidations of the causal mechanisms are important to prescribe and implement the most optimal training regimen in breast cancer prevention and treatment. The prevailing hypothesis on the positive association within exercise oncology has focused on lowering of the basal systemic levels of cancer risk factors with exercise training. However, another rather overlooked systemic exercise response is the marked acute increases in several potential anti-cancer components during each acute exercise bout. Here, we review the evidence of the exercise-mediated changes in systemic components with the ability to influence breast cancer progression. In the first part, we focus on systemic risk factors for breast cancer, i.e., sex hormones, insulin, and inflammatory markers, and their adaptation to long-term training. In the second part, we describe the systemic factors induced acutely during exercise, including catecholamines and myokines. In conclusion, we propose that the transient increases in exercise factors during acute exercise appear to be mediating the positive effect of regular exercise on breast cancer progression.
Collapse
Affiliation(s)
- Christine Dethlefsen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Katrine Seide Pedersen
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Pernille Hojman
- Centre of Inflammation and Metabolism (CIM) and Centre for Physical Activity Research (CFAS), Rigshospitalet, Faculty of Health Science, Copenhagen University Hospital, 7641, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| |
Collapse
|
53
|
Hwa YL, Shi Q, Kumar SK, Lacy MQ, Gertz MA, Kapoor P, Buadi FK, Leung N, Dingli D, Go RS, Hayman SR, Gonsalves WI, Russell S, Lust JA, Lin Y, Rajkumar SV, Dispenzieri A. Beta-blockers improve survival outcomes in patients with multiple myeloma: a retrospective evaluation. Am J Hematol 2017; 92:50-55. [PMID: 27733010 PMCID: PMC5217079 DOI: 10.1002/ajh.24582] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 10/07/2016] [Accepted: 10/11/2016] [Indexed: 12/28/2022]
Abstract
A preclinical study demonstrated anti-proliferative and apoptotic effect of propranolol on multiple myeloma (MM) cell. Clinical studies suggested that beta-blocker (BB) might impact the prognosis of breast, prostate, colorectal, ovarian, lung, and skin cancer. This retrospective study evaluated the effect of BB in MM disease-specific survival (DSS) and overall survival (OS). Among 1,971 newly diagnosed MM patients seen at Mayo Clinic between 1995 and 2010, usage of BB and other cardiac (or antihypertensive) medications were abstracted. Cumulative incidence function and Kaplan-Meier method were used to estimate 5-year cumulative incidence rate (CIR) of MM death and OS rate, respectively. Nine hundred and thirty (47.2%) patients had no intake of cardiac medications; 260 (13.2%) used BB alone; 343 (17.4%) used both BB/non-BB cardiac medications; and 438 (22.2%) had non-BB cardiac drugs. Superior MM DSS was observed in BB only users, compared to patients without any cardiac drugs ( HRadj.CS, 0.53, 95% confidence interval [CI], 0.42-0.67, Padj. <0.0001) and non-BB cardiac drugs users ( HRadj.CS, 0.49, 95% CI, 0.38-0.63, Padj. <0.0001). Patients on both BB and other cardiac drugs showed superior DSS than non-cardiac drugs users ( HRadj.CS, 0.54, 95% CI, 0.44-0.67, Padj. <0.0001) and non-BB cardiac drug users. ( HRadj.CS, 0.50, 95% CI, 0.40-0.62, Padj. <0.0001). MM DSS did not differ between BB users with and without other cardiac drugs (Padj. =0.90). Multivariable analysis showed the same pattern for OS. In patients with MM, BB intake is associated with a reduced risk of disease-specific death and overall mortality in comparison to non-BB or no use of cardiac drugs. Am. J. Hematol. 92:50-55, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Yi L. Hwa
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Qian Shi
- Division of Biomedical Statistics and Informatics, Department of Health Science Research; Mayo Clinic; Rochester MN
| | - Shaji K. Kumar
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Martha Q. Lacy
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Morie A. Gertz
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Prashant Kapoor
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Francis K. Buadi
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Nelson Leung
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
- Division of Nephrology and Hypertension, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - David Dingli
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Ronald S. Go
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Suzanne R. Hayman
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Wilson I. Gonsalves
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Stephen Russell
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - John A. Lust
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Yi Lin
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - S. Vincent Rajkumar
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| | - Angela Dispenzieri
- Division of Hematology, Department of Internal Medicine; Mayo Clinic; Rochester MN
| |
Collapse
|
54
|
Current Resources for Evidence-Based Practice, November/December 2016. J Obstet Gynecol Neonatal Nurs 2016; 45:845-856. [DOI: 10.1016/j.jogn.2016.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
55
|
Hefner J, Csef H. The Clinical Relevance of Beta Blockers in Ovarian Carcinoma: A Systematic Review. Geburtshilfe Frauenheilkd 2016; 76:1050-1056. [PMID: 27761025 DOI: 10.1055/s-0042-115016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The last ten years have seen hardly any improvement in the prognosis of ovarian carcinoma. There is a great need for new treatment strategies, and a recent retrospective study showing a survival advantage with the use of beta blockers met with a very positive response. This systematic review summarizes the current state of knowledge and research on the topic: A database analysis identified six clinical studies showing inconsistent results with respect to the administration of beta blockers and disease course. The 13 preclinical studies identified showed almost without exception both that catecholamines had detrimental effects on tumour progression, and that these effects could be influenced by pharmacological blockade. Overall the available evidence does not justify the use of beta blockers in clinical practice for ovarian carcinoma at the present time. This article also outlines details of research design required for further studies needed on the subject. Preclinical research findings are however very impressive: They not only form an important basis for the development of future clinical studies but also, through revealing new pathomechanisms, they already make an important contribution towards the development of new treatment strategies for ovarian carcinoma.
Collapse
Affiliation(s)
- J Hefner
- Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - H Csef
- Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| |
Collapse
|
56
|
Parker WP, Lohse CM, Zaid HB, Cheville JC, Boorjian SA, Leibovich BC, Thompson RH. Evaluation of beta-blockers and survival among hypertensive patients with renal cell carcinoma. Urol Oncol 2016; 35:36.e1-36.e6. [PMID: 27687543 DOI: 10.1016/j.urolonc.2016.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/12/2016] [Accepted: 08/22/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Beta-blocker use is associated with improved survival for multiple nonurologic malignancies. Our objective was to evaluate the association between beta-blocker use and survival among surgically managed hypertensive patients with clear-cell renal cell carcinoma (ccRCC). METHODS Hypertensive patients with ccRCC treated with either radical or partial nephrectomy between 2000 and 2010 were identified from our Nephrectomy Registry. Beta-blocker use within 90 days before surgery was identified. The associations between beta-blocker use and risk of disease progression, death from renal cell carcinoma (RCC), and all-cause mortality were assessed using Cox proportional hazards regression models. RESULTS In total, 913 hypertensive patients were identified who underwent either partial or radical nephrectomy for ccRCC. Of these, 104 (11%) had documented beta-blocker use within 90 days before surgery. At last follow-up (median 8.2y among survivors), 258 patients showed progression (median 1.6y following surgery), and 369 patients had died (median 4.1y following surgery), including 138 who died of RCC. After adjusting for PROG (progression-free survival) and SSIGN (cancer-specific survival) scores, beta-blocker use was not significantly associated with the risk of disease progression (hazard ratio [HR] = 0.94; 95% CI: 0.61-1.47; P = 0.80) or the risk of death from RCC (HR = 0.74; 95% CI: 0.38-1.41; P = 0.35). Similarly, on multivariable analysis adjusting for clinicopathologic features, there was not a significant association between beta-blocker use and the risk of all-cause mortality (HR = 0.83; 95% CI: 0.59-1.16; P = 0.27). CONCLUSIONS Beta-blocker use for hypertension within 90 days before surgery was not associated with the risk of progression, death from RCC, or death from any cause.
Collapse
|
57
|
Jalili M, Salehzadeh-Yazdi A, Yaghmaie M, Ghavamzadeh A, Alimoghaddam K. Cancerome: A hidden informative subnetwork of the diseasome. Comput Biol Med 2016; 76:173-7. [PMID: 27468170 DOI: 10.1016/j.compbiomed.2016.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 06/30/2016] [Accepted: 07/18/2016] [Indexed: 11/18/2022]
Abstract
Neoplastic disorders are a leading cause of mortality and morbidity worldwide. Studying the relationships between different cancers using high throughput-generated data may elucidate undisclosed aspects of cancer etiology, diagnosis, and treatment. Several studies have described relationships between different diseases based on genes, proteins, pathways, gene ontology, comorbidity, symptoms, and other features. In this study, we first constructed an integrated human disease network based on nine different biological aspects, including molecular, functional, and clinical features. Next, we extracted the cancerome as a cancer-related subnetwork. Further investigation of cancerome could reveal hidden mechanisms of cancer and could be useful in developing new diagnostic tests and effective new drugs.
Collapse
Affiliation(s)
- Mahdi Jalili
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Salehzadeh-Yazdi
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Systems Biology and Bioinformatics, University of Rostock, 18051 Rostock, Germany
| | - Marjan Yaghmaie
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Ghavamzadeh
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Alimoghaddam
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
58
|
Albini A, DeCensi A, Cavalli F, Costa A. Cancer Prevention and Interception: A New Era for Chemopreventive Approaches. Clin Cancer Res 2016; 22:4322-7. [PMID: 27220959 DOI: 10.1158/1078-0432.ccr-16-0695] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/13/2016] [Indexed: 01/22/2023]
Abstract
At several recent, internationally attended scientific meetings, including the American Association for Cancer Research (AACR)'s "Shaping the Future of Cancer Prevention: A Roadmap for Integrative Cancer Science and Public Health" summit in Leesburg (VA) and the AACR Annual Meeting in New Orleans, the focus on cancer prevention to reduce cancer-related deaths was extensively discussed with renewed attention and emphasis. Cancer prevention should be actively proposed even to healthy individuals, and not just to individuals with high cancer risk. We discuss evaluation of a high cancer risk versus the relatively low risk for side effects of chemopreventive agents. The concept of cancer interception, which is halting transformed cells from becoming malignant cancers, should be adopted for cancer prevention. Potential prevention/interception actions include adopting healthy life style and avoiding carcinogens, repressing inflammation and pathologic angiogenesis, controlling metabolism, correcting insulin resistance and other metabolic alterations. Current drugs with limited toxicity can be repurposed to reduce cancer incidence. Aspirin is now being recommended for the prevention of colorectal cancer and it prevents other neoplasms as well. Metformin and β-blockers could be valuable for reducing pancreatic and breast cancer onset. On the basis of the evaluation of cancer risk, we here call for personalized approaches for cancer prevention and preventive interception and we envisage a list of measures and potential guidelines for preventive and interceptive strategies to reduce cancer burden. Investment into translational research to bring these approaches into public health policies and in the clinic is urgently needed. Clin Cancer Res; 22(17); 4322-7. ©2016 AACR.
Collapse
Affiliation(s)
| | - Andrea DeCensi
- Medical Oncology, E.O. Ospedali Galliera, Genova, Italy and Division of Cancer Prevention and Genetics, European Institute of Oncology, Via Ripamonti 435, Milan 20141, Italy
| | - Franco Cavalli
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | | |
Collapse
|