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Huang Z, Huang L, Zhang C, Chen G, Mai H. Blocking β2-AR and Inhibiting COX-2: A Promising Approach to Suppress OSCC Development. Int Dent J 2024:S0020-6539(24)00166-7. [PMID: 39043526 DOI: 10.1016/j.identj.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/22/2024] [Accepted: 06/25/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVES β2-adrenergic receptor (β2-AR) and cyclooxygenase-2 (COX-2) are overexpressed in various malignant tumours including oral squamous cell carcinoma (OSCC), suggesting that they may contribute to the development of OSCC. This study aims to investigate the potential synergistic effect of β2-AR blockade and COX-2 inhibition on suppressing the development of OSCC. METHODS Effects of blocking β2-AR and inhibiting COX-2 on migration and invasion of OSCC cells were detected by wound-healing assay and transwell invasion assay. Western blot and enzyme-linked immunosorbent assay (ELISA) were used to detect the expression of genes related to the progression of OSCC. In vivo, OSCC xenograft models were established to evaluate the effect of combined treatment on survival time, tumour size, and submandibular lymph node metastasis. Immunohistochemistry, Western blot, and ELISA were used to detect the expression of invasion and metastasis relative genes. RESULTS In vitro, blocking β2-AR or inhibiting COX-2 alone could suppress invasion and metastasis of OSCC cells, and suppression with combined treatment was more significant. Expression of genes related to invasion and metastasis, including EGFR, TGF-β1, IL-1β, MMP2, and VEGFA, were downregulated significantly, especially in the combined treatment group. In vivo, the combined treatment could significantly prolong survival time in tumour-bearing mice and inhibit the growth of tumours. Furthermore, submandibular lymph node metastasis was less in the combined treatment group, and expression of the abovementioned genes was also downregulated. CONCLUSIONS The combination of β2-AR blockade and COX-2 inhibition can significantly suppress the development of OSCC via downregulating EGFR, TGF-β1, IL-1β, MMP2, and VEGFA. Findings suggest that the combined use of a β2-AR blocker and a COX-2 inhibitor could be a promising adjuvant therapy in OSCC. Both drugs are commonly prescribed, and their safety and efficacy are well established. Their use in adjuvants in OSCC should therefore be promoted in clinical practice.
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Affiliation(s)
- Zeliu Huang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China
| | - Laifeng Huang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China
| | - Chong Zhang
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China
| | - Guosheng Chen
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China
| | - Huaming Mai
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China; Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China.
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Hathaway CA, Townsend MK, Sklar EM, Thomas-Purcell KB, Terry KL, Trabert B, Tworoger SS. The Association of Kidney Function and Inflammatory Biomarkers with Epithelial Ovarian Cancer Risk. Cancer Epidemiol Biomarkers Prev 2023; 32:1451-1457. [PMID: 37540498 PMCID: PMC10592177 DOI: 10.1158/1055-9965.epi-23-0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND One of the mechanisms of ovarian tumorigenesis is through inflammation. Kidney dysfunction is associated with increased inflammation; thus, we assessed its relationship with ovarian cancer risk. METHODS In prospectively collected samples, we evaluated the association of kidney function markers and C-reactive protein (CRP) with ovarian cancer risk in the UK Biobank. We used multivariable-adjusted Cox proportional hazards models to evaluate quartiles of serum and urine markers with ovarian cancer risk overall and by histology. We assessed effect modification by CRP (≤3.0, >3.0 mg/L). RESULTS Among 232,908 women (1,110 ovarian cancer cases diagnosed from 2006-2020), we observed no association between estimated glomerular filtration rate and ovarian cancer risk (Q4 vs. Q1: HR, 1.00; 95% confidence intervals, 0.83-1.22). Potassium was associated with endometrioid (Q4 vs. Q1: 0.33, 0.11-0.98) and clear cell (4.74, 1.39-16.16) tumors. Poor kidney function was associated with a nonsignificant increase in ovarian cancer risk among women with CRP>3.0 mg/L (e.g., uric acid Q4 vs. Q1; 1.23, 0.81-1.86), but not CRP≤3.0 mg/L (0.83, 0.66-1.05). Other associations did not vary across CRP categories. CONCLUSIONS Kidney function was not clearly associated with ovarian cancer risk. Larger studies are needed to evaluate possible histology specific associations. Given the suggestive trend for increased ovarian cancer risk in women with poor kidney function and high CRP, future work is needed, particularly in populations with a high prevalence of inflammatory conditions. IMPACT This study provided the first evaluation of markers of kidney function in relation to ovarian cancer risk.
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Affiliation(s)
- Cassandra A. Hathaway
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Mary K. Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Elliot M. Sklar
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Kamilah B. Thomas-Purcell
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Kathryn L. Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School; Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Britton Trabert
- Department of Obstetrics and Gynecology, University of Utah and Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
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Tuesley KM, Spilsbury K, Webb PM, Protani MM, Dixon-Suen S, Pearson SA, Donovan P, Coory MD, Steer CB, Stewart LM, Pandeya N, Jordan SJ. Association between antihypertensive medicine use and risk of ovarian cancer in women aged 50 years and older. Cancer Epidemiol 2023; 86:102444. [PMID: 37595337 DOI: 10.1016/j.canep.2023.102444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Epithelial ovarian cancer (EOC) has few modifiable risk factors. There is evidence that some antihypertensive medicines may have cancer preventive and/or therapeutic actions; therefore, we assessed the associations between use of different antihypertensive medicines and risk of specific EOC histotypes. METHODS Our nested case-control study of linked administrative health data included 6070 Australian women aged over 50 years diagnosed with EOC from 2004 to 2013, and 30,337 matched controls. We used multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for the association between ever use of each antihypertensive medicine group, including beta-adrenergic blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and alpha blockers, and the risk of EOC overall and separately for the serous, endometrioid, mucinous, clear cell and other histotypes. RESULTS We found that most antihypertensive medicines were not associated with risk of EOC. However, women who used calcium channel blockers had a reduced risk of serous EOC (OR= 0.89, 95 % CI:0.81,0.98) and use of combination thiazide and potassium-sparing diuretics was associated with an increased risk of endometroid EOC (OR= 2.09, 95 % CI:1.15,3.82). CONCLUSION Our results provide little support for a chemo-preventive role for most antihypertensives, however, the histotype-specific associations we found warrant further investigation.
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Affiliation(s)
- Karen M Tuesley
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Katrina Spilsbury
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
| | - Penelope M Webb
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Melinda M Protani
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Suzanne Dixon-Suen
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Sallie-Anne Pearson
- School of Population Health, University of New South Wales, Sydney, Australia; Centre of Research Excellence in Medicines Intelligence, University of New South Wales, Sydney, Australia
| | - Peter Donovan
- Clinical Pharmacology Department, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Michael D Coory
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Christopher B Steer
- Border Medical Oncology, Albury-Wodonga Regional Cancer Centre, Albury, Australia; University of NSW Rural Clinical School, Albury Campus, Albury, New South Wales, Australia
| | - Louise M Stewart
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Nirmala Pandeya
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Susan J Jordan
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Zhang Y, Wang QL, Yuan C, Lee AA, Babic A, Ng K, Perez K, Nowak JA, Lagergren J, Stampfer MJ, Giovannucci EL, Sander C, Rosenthal MH, Kraft P, Wolpin BM. Pancreatic cancer is associated with medication changes prior to clinical diagnosis. Nat Commun 2023; 14:2437. [PMID: 37117188 PMCID: PMC10147931 DOI: 10.1038/s41467-023-38088-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
Patients with pancreatic ductal adenocarcinoma (PDAC) commonly develop symptoms and signs in the 1-2 years before diagnosis that can result in changes to medications. We investigate recent medication changes and PDAC diagnosis in Nurses' Health Study (NHS; females) and Health Professionals Follow-up Study (HPFS; males), including up to 148,973 U.S. participants followed for 2,994,057 person-years and 991 incident PDAC cases. Here we show recent initiation of antidiabetic (NHS) or anticoagulant (NHS, HFS) medications and cessation of antihypertensive medications (NHS, HPFS) are associated with pancreatic cancer diagnosis in the next 2 years. Two-year PDAC risk increases as number of relevant medication changes increases (P-trend <1 × 10-5), with participants who recently start antidiabetic and stop antihypertensive medications having multivariable-adjusted hazard ratio of 4.86 (95%CI, 1.74-13.6). These changes are not associated with diagnosis of other digestive system cancers. Recent medication changes should be considered as candidate features in multi-factor risk models for PDAC, though they are not causally implicated in development of PDAC.
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Affiliation(s)
- Yin Zhang
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Qiao-Li Wang
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Clinical Science, Intervention and Technology, Karolinka Institutet, Stockholm, Sweden
| | - Chen Yuan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Alice A Lee
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ana Babic
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Kimberly Perez
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Meir J Stampfer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Chris Sander
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Michael H Rosenthal
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brian M Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
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Kidoguchi S, Sugano N, Yokoo T, Kaneko H, Akazawa H, Mukai M, Node K, Yano Y, Nishiyama A. Antihypertensive Drugs and Cancer Risk. Am J Hypertens 2022; 35:767-783. [PMID: 35595533 DOI: 10.1093/ajh/hpac066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 05/18/2022] [Indexed: 02/07/2023] Open
Abstract
Hypertension is the most prevalent comorbidity in cancer patients. Consequently, many cancer patients are prescribed antihypertensive drugs before cancer diagnosis or during cancer treatment. However, whether antihypertensive drugs affect the incidence, treatment efficacy, or prognosis of cancer remains unanswered. For instance, renin-angiotensin and β-adrenergic signaling may be involved not only in blood pressure elevation but also in cell proliferation, angiogenesis, and tissue invasion. Therefore, the inhibition of these pathways may have beneficial effects on cancer prevention or treatment. In this article, we reviewed several studies regarding antihypertensive drugs and cancer. In particular, we focused on the results of clinical trials to evaluate whether the use of antihypertensive drugs affects future cancer risk and prognosis. Unfortunately, the results are somewhat inconsistent, and evidence demonstrating the effect of antihypertensive drugs remains limited. We indicate that the heterogeneity in the study designs makes it difficult to clarify the causal relationship between antihypertensive drugs and cancer. We also propose that additional experimental studies, including research with induced pluripotent cells derived from cancer patients, single-cell analyses of cancer cell clusters, and clinical studies using artificial intelligence electronic health record systems, might be helpful to reveal the precise association between antihypertensive drugs and cancer risk.
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Affiliation(s)
- Satoshi Kidoguchi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.,Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Naoki Sugano
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.,Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Mikio Mukai
- Osaka Prefectural Hospital Organization, Osaka International Cancer Institute, Department of Medical Check-up, Osaka, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yuichiro Yano
- Department of Advanced Epidemiology, NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Zhang X, Yang J, Chen S, Liu C, Wang Z, Ren H, Zhou L. Pre-existing hypertension is associated with poor progression-free survival in newly diagnosed multiple myeloma patients. J Thromb Thrombolysis 2022; 54:542-549. [PMID: 35445377 DOI: 10.1007/s11239-022-02653-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2022] [Indexed: 11/29/2022]
Abstract
Approximately 31% of patients diagnosed with multiple myeloma (MM) have pre-existing hypertension, but its effects on patient survival have not been investigated. We collected data from 228 newly diagnosed patients with MM and found that 71 (31.1%) had pre-existing hypertension. The impact of pre-existing hypertension on MM patients was determined by evaluating progression-free survival (PFS). Kaplan-Meier analyses revealed a significantly lower PFS in the pre-existing hypertension group than their non-hypertensive counterparts (median 22.6 vs 34.8 months, respectively). The multivariable Cox proportional hazards model showed that pre-existing hypertension was an independent risk factor for PFS reduction in MM patients. Moreover, the risk of disease progression in MM patients with pre-existing hypertension was higher than in non-hypertension comparator patients (hazard ratio 1.735, 95% confidence interval 1.261-2.387). In MM patients with pre-existing hypertension, Kaplan-Meier analyses found that those with a higher risk of hypertension had a significantly shorter PFS than those with lower risk (median 19.3 vs 25.4 months, respectively). However, multivariate Cox regression analysis showed that the risk stratification of hypertension was not an independent risk factor for poor PFS in MM patients with pre-existing hypertension. Our study demonstrates that pre-existing hypertension was significantly associated with a lower PFS in newly diagnosed MM patients.
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Affiliation(s)
- Xiaomin Zhang
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Jieli Yang
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Sai Chen
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Chang Liu
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Zhenhua Wang
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Hefei Ren
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Lin Zhou
- Department of Laboratory Medicine, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
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Huang T, Townsend MK, Dood RL, Sood AK, Tworoger SS. Antihypertensive medication use and ovarian cancer survival. Gynecol Oncol 2021; 163:342-347. [PMID: 34556331 DOI: 10.1016/j.ygyno.2021.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although experimental models suggest that use of beta-blockers, a common antihypertensive agent, may improve survival in ovarian cancer patients, results from clinical studies have been mixed. METHODS We evaluated the associations of pre-diagnostic (n = 950) and post-diagnostic (n = 743) use of antihypertensive medications with survival among patients with invasive, epithelial ovarian cancer in the Nurses' Health Study (NHS; 1994-2016) and NHSII (2001-2017), with follow-up until 2018 and 2019, respectively. Cox proportional hazards models were used to estimate hazard ratios (HR) for ovarian cancer mortality according to antihypertensive medication use before and after diagnosis, considering multiple drug classes (beta-blockers, calcium-channel blockers, thiazide diuretics, angiotensin-converting enzyme [ACE] inhibitors). RESULTS After adjusting for age, BMI, smoking status and tumor characteristics, pre-diagnostic use versus non-use of calcium-channel blockers was associated with higher ovarian cancer mortality (HR: 1.49; 95% CI: 1.13, 1.96), which was primarily due to polytherapy involving calcium-channel blockers (HR: 1.61; 95% CI: 1.15, 2.26). Pre-diagnostic use of beta-blockers, thiazide diuretics, or ACE inhibitors was not associated with ovarian cancer mortality. No association was observed for post-diagnostic antihypertensive medication use individually or in combination, except for lower mortality associated with polytherapy involving ACE inhibitors (HR: 0.53; 95% CI: 0.31, 0.91). CONCLUSION Overall, we did not find clear relationships between antihypertensive medication use and ovarian cancer mortality. However, given the limitation of the data, we cannot determine whether the association may differ by type of beta-blockers. The reasons underlying the observed associations with pre-diagnostic calcium-channel blocker use and post-diagnostic ACE inhibitor use require further investigation.
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Affiliation(s)
- Tianyi Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - Mary K Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Robert L Dood
- Department of Obstetrics and Gynecology, The University of Utah School of Medicine, Salt Lake City, UT, United States of America
| | - Anil K Sood
- Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, TX, United States of America
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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8
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Mravec B. Neurobiology of Cancer: Introduction of New Drugs in the Treatment and Prevention of Cancer. Int J Mol Sci 2021; 22:6115. [PMID: 34204103 PMCID: PMC8201304 DOI: 10.3390/ijms22116115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/21/2022] Open
Abstract
Research on the neurobiology of cancer, which lies at the border of neuroscience and oncology, has elucidated the mechanisms and pathways that enable the nervous system to modulate processes associated with cancer initiation and progression. This research has also shown that several drugs which modulate interactions between the nervous system and the tumor micro- and macroenvironments significantly reduced the progression of cancer in animal models. Encouraging results were also provided by prospective clinical trials investigating the effect of drugs that reduce adrenergic signaling on the course of cancer in oncological patients. Moreover, it has been shown that reducing adrenergic signaling might also reduce the incidence of cancer in animal models, as well as in humans. However, even if many experimental and clinical findings have confirmed the preventive and therapeutic potential of drugs that reduce the stimulatory effect of the nervous system on processes related to cancer initiation and progression, several questions remain unanswered. Therefore, the aim of this review is to critically evaluate the efficiency of these drugs and to discuss questions that need to be answered before their introduction into conventional cancer treatment and prevention.
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Affiliation(s)
- Boris Mravec
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 813 72 Bratislava, Slovakia; ; Tel.: +421-(2)-59357527; Fax: +421-(2)-59357601
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, 845 05 Bratislava, Slovakia
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Antihypertensive drugs and the risk of cancer: a critical review of available evidence and perspective. J Hypertens 2021; 38:1005-1015. [PMID: 32371788 DOI: 10.1097/hjh.0000000000002379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
: The issue of a potential danger of antihypertensive drugs related to cancer susceptibility is currently generating a major debate in the scientific community, concerns in the public and emphasized interest from the media. The present article is a thorough review of what is known on the various classes of antihypertensive drugs concerning the risk of developing different neoplasms and about the suggested pathophysiological mechanisms, whenever available. The main limitations of evidence derived from studies currently available in this setting are also discussed, high-lightening the need for newly developed approaches to generate more accurate recommendations and informed advice for physicians.
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10
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Antihypertensive Drug Use and the Risk of Ovarian Cancer Death among Finnish Ovarian Cancer Patients-A Nationwide Cohort Study. Cancers (Basel) 2021; 13:cancers13092087. [PMID: 33925829 PMCID: PMC8123393 DOI: 10.3390/cancers13092087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary According to the literature, antihypertensive drugs may affect the survival of ovarian cancer patients. We examined the association between different groups of antihypertensive drugs and ovarian cancer survival taking into account dose and duration of use as well as the simultaneous use of other drugs. With a 5-year follow-up, antihypertensive drugs were not associated with survival from ovarian cancer but with 10-year follow-up, ACE-inhibitors and with longer follow-up times also other antihypertensive drugs were associated with improved survival from ovarian cancer. The association between ACE-inhibitor use and ovarian cancer survival should be clarified in the future. Abstract Ovarian cancer (OC) has a poor prognosis. Hypertension may be a prognostic factor for OC, but it is unclear whether antihypertensive (anti-HT) drug use of modifies OC prognosis. We performed a population-based analysis assessing the effect of anti-HT drug use on OC mortality. A cohort of 12,122 women identified from the Finnish Cancer Registry with OC in 1995–2013 was combined with information on their anti-HT drug use during the same time period. Use of each anti-HT drug was analysed as a time-dependent variable. Analyses were run for five, ten and full follow-up (19-year) mortality with cardiovascular morbidity risk evaluated in competing risk analysis. No anti-HT drug group was associated with OC survival within five years after OC diagnosis. At ten years, a dose-dependent association was observed between pre-diagnostic ACE-inhibitor use and improved OC survival. With full follow-up, post-diagnostic high-intensity use associated with reduced OC death risk for multiple anti-HT drug groups. In competing risk analysis, only the post-diagnostic use of ACE-inhibitors associated with increased OC survival. Anti-HT drugs were not associated with survival benefits within five years after OC diagnosis. ACE-inhibitors may confer survival benefits in women with OC, but further confirmatory studies are needed.
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Sanidas E, Velliou M, Papadopoulos D, Fotsali A, Iliopoulos D, Mantzourani M, Toutouzas K, Barbetseas J. Antihypertensive Drugs and Risk of Cancer: Between Scylla and Charybdis. Am J Hypertens 2020; 33:1049-1058. [PMID: 32529212 DOI: 10.1093/ajh/hpaa098] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/21/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Abstract
Antihypertensive drugs namely angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, beta blockers, and diuretics are among the most clearly documented regimens worldwide with an overall cardioprotective benefit. Given that malignancy is the second leading cause of mortality, numerous observational studies aimed to investigate the carcinogenic potential of these agents with conflicting results. The purpose of this review was to summarize current data in an effort to explore rare side effects and new mechanisms linking antihypertensive drugs with the risk of developing cancer.
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Affiliation(s)
- Elias Sanidas
- Hypertension Excellence Centre—ESH, Department of Cardiology, LAIKO General Hospital, Athens, Greece
| | - Maria Velliou
- Hypertension Excellence Centre—ESH, Department of Cardiology, LAIKO General Hospital, Athens, Greece
| | - Dimitrios Papadopoulos
- Hypertension Excellence Centre—ESH, Department of Cardiology, LAIKO General Hospital, Athens, Greece
| | - Anastasia Fotsali
- Hypertension Excellence Centre—ESH, Department of Cardiology, LAIKO General Hospital, Athens, Greece
| | - Dimitrios Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, University of Athens, Medical School, Athens, Greece
| | - Marina Mantzourani
- 1st Department of Internal Medicine, LAIKO General Hospital, University of Athens, Medical School, Athens, Greece
| | - Konstantinos Toutouzas
- University of Athens, 1st Department of Cardiology, Hippokrateion Hospital, Athens, Greece
| | - John Barbetseas
- Hypertension Excellence Centre—ESH, Department of Cardiology, LAIKO General Hospital, Athens, Greece
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12
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Cardiometabolic comorbidities and epithelial ovarian cancer risk among African-American women in the African-American Cancer Epidemiology Study (AACES). Gynecol Oncol 2020; 158:123-129. [PMID: 32362566 DOI: 10.1016/j.ygyno.2020.04.700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Studies that have examined the association between cardiovascular comorbidities and epithelial ovarian cancer (EOC) have yielded inconsistent results. It remains unknown whether cardiometabolic disease is associated with EOC in African American (AA) women, who have a higher prevalence of cardiovascular disease and lower risk of EOC than White women. Here, we estimate the effect of cardiovascular comorbid conditions and EOC risk among AA women. METHODS Data were available from 593 ovarian carcinoma patients and 752 controls enrolled in the African American Cancer Epidemiology Study (AACES). Participants were asked to self-report a history of hypertension, hyperlipidemia, and diabetes and any current medication use. The relationship between hypertension, hyperlipidemia, diabetes, and medications taken for these conditions was determined using multivariate logistic regression. RESULTS Hypertension was associated with an increased risk (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.01, 1.73), whereas diabetes and hyperlipidemia were associated with a decreased risk (aOR = 0.67, 95% CI = 0.49, 0.91 and aOR = 0.61, 95% CI = 0.47, 0.80, respectively) of EOC. Use of anti-diabetic medication was inversely associated with EOC risk, as was use of lipid lowering medications (in the overall study population), which were predominantly statins. Among women with hypertension, use of anti-hypertensive medications was inversely associated with EOC risk, with associations that were most pronounced for diuretics, ARBs and ACE inhibitors. CONCLUSION Hypertension was associated with an increased EOC risk in this patient population, whereas an inverse association was observed for diabetes and hyperlipidemia. The decreased risk of EOC identified with use of anti-hypertensive, anti-diabetes or lipid-lowering medications could have implications for risk reduction strategies.
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13
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Zeleznik OA, Eliassen AH, Kraft P, Poole EM, Rosner BA, Jeanfavre S, Deik AA, Bullock K, Hitchcock DS, Avila-Pacheco J, Clish CB, Tworoger SS. A Prospective Analysis of Circulating Plasma Metabolites Associated with Ovarian Cancer Risk. Cancer Res 2020; 80:1357-1367. [PMID: 31969373 DOI: 10.1158/0008-5472.can-19-2567] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/16/2019] [Accepted: 01/17/2020] [Indexed: 12/13/2022]
Abstract
Ovarian cancer has few known risk factors, hampering identification of high-risk women. We assessed the association of prediagnostic plasma metabolites (N = 420) with risk of epithelial ovarian cancer, including both borderline and invasive tumors. A total of 252 cases and 252 matched controls from the Nurses' Health Studies were included. Multivariable logistic regression was used to estimate ORs and 95% confidence intervals (CI), comparing the 90th-10th percentile in metabolite levels, using the permutation-based Westfall and Young approach to account for testing multiple correlated hypotheses. Weighted gene coexpression network analysis (WGCNA; n = 10 metabolite modules) and metabolite set enrichment analysis (n = 23 metabolite classes) were also evaluated. An increase in pseudouridine levels from the 10th to the 90th percentile was associated with a 2.5-fold increased risk of overall ovarian cancer (OR = 2.56; 95% CI, 1.48-4.45; P = 0.001/adjusted P = 0.15); a similar risk estimate was observed for serous/poorly differentiated tumors (n = 176 cases; comparable OR = 2.38; 95% CI, 1.33-4.32; P = 0.004/adjusted P = 0.55). For nonserous tumors (n = 34 cases), pseudouridine and C36:2 phosphatidylcholine plasmalogen had the strongest statistical associations (OR = 9.84; 95% CI, 2.89-37.82; P < 0.001/adjusted P = 0.07; and OR = 0.11; 95% CI, 0.03-0.35; P < 0.001/adjusted P = 0.06, respectively). Five WGCNA modules and 9 classes were associated with risk overall at FDR ≤ 0.20. Triacylglycerols (TAG) showed heterogeneity by tumor aggressiveness (case-only heterogeneity P < 0.0001). The TAG association with risk overall and serous tumors differed by acyl carbon content and saturation. In summary, this study suggests that pseudouridine may be a novel risk factor for ovarian cancer and that TAGs may also be important, particularly for rapidly fatal tumors, with associations differing by structural features. SIGNIFICANCE: Pseudouridine represents a potential novel risk factor for ovarian cancer and triglycerides may be important particularly in rapidly fatal ovarian tumors.
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Affiliation(s)
- Oana A Zeleznik
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - A Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sarah Jeanfavre
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Amy A Deik
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Kevin Bullock
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Daniel S Hitchcock
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Julian Avila-Pacheco
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Clary B Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. .,Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
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14
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Michels KA, McNeel TS, Trabert B. Metabolic syndrome and risk of ovarian and fallopian tube cancer in the United States: An analysis of linked SEER-Medicare data. Gynecol Oncol 2019; 155:294-300. [PMID: 31495456 PMCID: PMC6825892 DOI: 10.1016/j.ygyno.2019.08.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To clarify associations between metabolic syndrome, its components, and ovarian cancer risk. METHODS Using a case-control study within the U.S.-based Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, we examined metabolic syndrome, its components (obesity, impaired fasting glucose, hypertension, HDL cholesterol, triglycerides), and ovarian/fallopian tube cancer risk. Cases (n = 16,850) were diagnosed with cancer between age 68-89 from 1994 through 2013. Controls (n = 281,878) were Medicare enrollees without these cancers living in registry areas. We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) with logistic regression. RESULTS Women with metabolic syndrome had reduced ovarian cancer risk compared to women not meeting the diagnostic criteria (OR 0.86, CI 0.82-0.89). Having one or two syndrome components was associated with increased risk, but having ≥3 was not, when compared to women without any components. Impaired fasting glucose, which was highly prevalent among those with metabolic syndrome, was associated with reduced risk (OR 0.90, CI 0.87-0.93). Hypertension and high triglycerides, the most prevalent components among women without metabolic syndrome, were associated with increased risks (OR 1.08, CI 1.04-1.12; OR 1.05, CI 1.01-1.08, respectively). CONCLUSIONS Specific metabolic syndrome components may have modest associations with ovarian cancer. These associations varied in direction and the prevalence of the components influenced the overall association between metabolic syndrome and ovarian cancer. Evaluating metabolic syndrome as a composite exposure could be misleading in ovarian cancer research, but further study of the syndrome components is warranted.
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Affiliation(s)
- Kara A Michels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America.
| | - Timothy S McNeel
- Information Management Services, Inc., Calverton, MD, United States of America
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America
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15
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Harding BN, Delaney JA, Urban RR, Weiss NS. Post-diagnosis use of antihypertensive medications and the risk of death from ovarian cancer. Gynecol Oncol 2019; 154:426-431. [PMID: 31178150 DOI: 10.1016/j.ygyno.2019.05.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To examine associations between post-diagnosis use of antihypertensive (AH) medications including thiazide diuretics (TDs), angiotensin converting enzyme inhibitors (ACEIs), beta blockers (BBs) [both non-selective (NSBBs) and selective (SBBs)] and calcium channel blockers (CCBs) and ovarian cancer-specific survival. METHODS This cohort study used SEER-Medicare data on 2195 women 66+ years of age who were diagnosed with ovarian cancer during 2007-2012 and who survived for at least 12 months. Use of an AH class was defined as two or more fills during the year after diagnosis. Ovarian cancer-specific death was assessed starting one year after diagnosis and continued through the end of 2013. Associations between AH use and ovarian cancer-specific mortality were assessed using Cox proportional hazard models, comparing users of a given class of AH to non-AH users. RESULTS Overall, 718 (33%), 690 (31%), 521 (24%), 154 (7%) of women used a TD, ACEI, BB, or CCB, respectively, with some women (48%) using more than one class of drug. Ovarian cancer-specific mortality was found to be lower among women who used an ACEI (adjusted hazard ratio [aHR] 0.76, 95% confidence interval [CI] 0.63-0.92), a TD (aHR 0.82, 95%CI 0.68-0.99), or a NSBB (aHR 0.60, 95%CI 0.43-0.83), but no such association was seen in women who took a SBB or CCB. CONCLUSION We observed that women who took certain forms of an AH medication during the year following a diagnosis of ovarian cancer were thereafter at a relatively reduced risk of dying from their disease. However, the potential for residual confounding by disease severity argues for a cautious interpretation.
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Affiliation(s)
- Barbara N Harding
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America.
| | - Joseph A Delaney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Renata R Urban
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States of America
| | - Noel S Weiss
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America
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16
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Intriguing relationship between antihypertensive therapy and cancer. Pharmacol Res 2019; 141:501-511. [DOI: 10.1016/j.phrs.2019.01.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022]
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17
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Tadic M, Cuspidi C, Grassi G, Ivanovic B. Gender-specific therapeutic approach in arterial hypertension - Challenges ahead. Pharmacol Res 2018; 141:181-188. [PMID: 30584913 DOI: 10.1016/j.phrs.2018.12.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/17/2022]
Abstract
Hypertension was thought to be more important cardiovascular risk factor in men than in women. However, studies showed that overall incidence of hypertension-related cardiovascular diseases is higher in women comparing with men and this is particularly valid in menopause when prevalence of hypertension and its complications sharply and suddenly rises. It was also noticed that the effect of various antihypertensive groups was different in women and men. Some medications are prescribed more often in women, but it does not necessary mean that these drugs are more effective in this gender. There are several important reasons that could explain gender-induced differences in blood pressure levels, blood pressure control and antihypertensive treatment. They involve sex hormones, the renin-angiotensin-aldosterone and sympathetic nervous system, and arterial stiffness. However, taking into account many observational studies and trials, there are no consistent data regarding the impact of gender on effect of antihypertensive medications. Longitudinal study focused on gender and current antihypertensive groups would significantly help to understand the impact of gender. This might change therapeutic approach and improve cost-effectiveness in antihypertensive therapy in both genders. A full understanding of the pathophysiological characteristics of variations between genders demands additional research. This review article summarized the current knowledge regarding differences in the prevalence and awareness of arterial hypertension in women and men; alterations in pathophysiological mechanisms of hypertension between sexes; as well as the impact of sex on the effects of main antihypertensive groups of medications.
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Affiliation(s)
- Marijana Tadic
- Charité - Universitätsmedizin Berlin, Department of Internal Medicine and Cardiology, Augustenburgerplatz 1, 13353, Berlin, Germany.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036, Meda, Italy
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University Milano-Bicocca, Milano, Italy
| | - Branislava Ivanovic
- Clinical Centre of Serbia, Cardiology Clinic, Koste Todorovica 6, 11000, Belgrade, Serbia
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18
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Wagner MJ, Cranmer LD, Loggers ET, Pollack SM. Propranolol for the treatment of vascular sarcomas. J Exp Pharmacol 2018; 10:51-58. [PMID: 30233257 PMCID: PMC6130307 DOI: 10.2147/jep.s146211] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Vascular sarcomas are abnormal proliferations of endothelial cells. They range from benign hemangioma to aggressive angiosarcoma, and are characterized by dysregulated angiogenic signaling. Propranolol is a β-adrenergic receptor inhibitor that has demonstrated clinical efficacy in benign infantile hemangioma, and is now being used experimentally for more aggressive vascular sarcomas and other cancers. In this review, we discuss the use of propranolol in targeting these receptors in vascular tumors and other cancers.
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Affiliation(s)
- Michael J Wagner
- Division of Medical Oncology, .,Clinical Research Division University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, USA,
| | - Lee D Cranmer
- Division of Medical Oncology, .,Clinical Research Division University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, USA,
| | - Elizabeth T Loggers
- Division of Medical Oncology, .,Clinical Research Division University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, USA,
| | - Seth M Pollack
- Division of Medical Oncology, .,Clinical Research Division University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, USA,
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19
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Hamada T, Khalaf N, Yuan C, Morales-Oyarvide V, Babic A, Nowak JA, Qian ZR, Ng K, Rubinson DA, Kraft P, Giovannucci EL, Stampfer MJ, Fuchs CS, Ogino S, Wolpin BM. Prediagnosis Use of Statins Associates With Increased Survival Times of Patients With Pancreatic Cancer. Clin Gastroenterol Hepatol 2018; 16:1300-1306.e3. [PMID: 29474971 PMCID: PMC6056316 DOI: 10.1016/j.cgh.2018.02.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/29/2018] [Accepted: 02/11/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Statin medications, most commonly prescribed to reduce lipid levels and prevent cardiovascular disease, may be associated with longer survival times of patients with cancer. However, the association of statins with outcomes of patients with pancreatic adenocarcinoma is not clear. METHODS We analyzed the association of statin use before a diagnosis of pancreatic cancer with survival times of 648 participants in the Nurses' Health Study and Health Professionals Follow-up Study who were diagnosed with pancreatic adenocarcinoma from 2000 through 2013. We estimated hazard ratios (HRs) for overall mortality using Cox proportional hazards models with adjustment for potential confounders. We assessed the temporal association between prediagnosis statin use and cancer survival by 2-year lag periods to account for a possible latency period between statin use and cancer survival. RESULTS Regular statin use before diagnosis of pancreatic cancer was associated with modestly prolonged survival compared with nonregular use (adjusted HR, 0.82; 95% CI, 0.69-0.97; P = .02). A 1-month longer median survival was observed in regular statin users compared with nonregular users. Regular statin use within the 2 years prior to cancer diagnosis was most strongly associated with longer survival. We observed no statistically significant effect modification by smoking status, body mass index, diabetes, or cancer stage (all Pinteraction > .53). Regular statin use before diagnosis was similarly associated with survival in the Nurses' Health Study (HR, 0.79; 95% CI, 0.64-0.97) and Health Professionals Follow-up Study (HR, 0.86; 95% CI, 0.63-1.15). CONCLUSIONS Regular statin use before diagnosis of pancreatic cancer was associated with modest increases in survival times in 2 large prospective cohort studies.
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Affiliation(s)
- Tsuyoshi Hamada
- Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Natalia Khalaf
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Chen Yuan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Vicente Morales-Oyarvide
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Ana Babic
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Zhi Rong Qian
- Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Douglas A Rubinson
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Peter Kraft
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Meir J Stampfer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Charles S Fuchs
- Yale Cancer Center, New Haven, Connecticut; Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Smilow Cancer Hospital, New Haven, Connecticut
| | - Shuji Ogino
- Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Brian M Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.
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20
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Doherty JA, Jensen A, Kelemen LE, Pearce CL, Poole E, Schildkraut JM, Terry KL, Tworoger SS, Webb PM, Wentzensen N. Current Gaps in Ovarian Cancer Epidemiology: The Need for New Population-Based Research. J Natl Cancer Inst 2017; 109:3847624. [PMID: 29117355 DOI: 10.1093/jnci/djx144] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022] Open
Abstract
With recent ovarian cancer screening studies showing no clinically significant mortality benefit, preventing this disease, identifying high-risk populations, and extending survival remain priorities. However, several challenges are impeding progress in ovarian cancer research. With most studies capturing exposure information from 10 or more years ago, evaluation of how changing patterns of exposures, such as new oral contraceptive formulations and increased intrauterine device use, might influence ovarian cancer risk and survival is difficult. Risk factors for ovarian cancer should be evaluated in the context of tumor histotypes, which have unique molecular features and cells of origin; this is a task that requires large collaborative studies to achieve meaningful sample sizes. Importantly, identification of novel modifiable risk factors, in addition to those currently known to reduce risk (eg, childbearing, tubal ligation, oral contraceptive use), is needed; this is not feasibly implemented at a population level. In this Commentary, we describe important gaps in knowledge and propose new approaches to advance epidemiologic research to improve ovarian cancer prevention and survival, including updated classification of tumors, collection of data on changing and novel exposures, longer follow-up on existing studies, evaluation of diverse populations, development of better risk prediction models, and collaborating prospectively with consortia to develop protocols for new studies that will allow seamless integration for future pooled analyses.
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Affiliation(s)
| | - Jennifer A Doherty
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Allan Jensen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Linda E Kelemen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Celeste L Pearce
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Elizabeth Poole
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Joellen M Schildkraut
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Kathryn L Terry
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Shelley S Tworoger
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Penelope M Webb
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Nicolas Wentzensen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
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21
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Ni H, Rui Q, Zhu X, Yu Z, Gao R, Liu H. Antihypertensive drug use and breast cancer risk: a meta-analysis of observational studies. Oncotarget 2017; 8:62545-62560. [PMID: 28977968 PMCID: PMC5617528 DOI: 10.18632/oncotarget.19117] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 04/14/2017] [Indexed: 12/14/2022] Open
Abstract
We conducted a meta-analysis of observational studies to examine the hypothesized association between breast cancer and antihypertensive drug (AHT) use. Fixed- or random- effect models were used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for all AHTs and individual classes (i.e., angiotensin-converting enzyme inhibitors, [ACEi]; angiotensin-receptor blockers, [ARBs]; calcium channel blockers, [CCBs]; beta-blockers, [BBs], and diuretics). Twenty-one studies with 3,116,266 participants were included. Overall, AHT use was not significantly associated with breast cancer risk (RR = 1.02, 95% CI: 0.98-1.06), and no consistent association was found for specific AHT classes with pooled RRs of 1.02 (95% CI: 0.96-1.09) for BBs, 1.07 (95% CI: 0.99-1.16) for CCBs, 0.99 (95% CI: 0.93-1.05) for ACEi/ARBs, and 1.05 (95% CI: 0.99-1.12) for diuretics. When stratified by duration of use, there was a significantly reduced breast cancer risk for ACEi/ARB use ≥10 years (RR = 0.80, 95% CI: 0.67-0.95). Although there was no significant association between AHT use and breast cancer risk, there was a possible beneficial effect was found for long-term ACEi/ARB. Large, randomized controlled trials with long-term follow-up are needed to further test the effect of these medications on breast cancer risk.
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Affiliation(s)
- Haibo Ni
- Department of Neurosurgery, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China
| | - Qin Rui
- Department of Laboratory, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China
| | - Xiaojue Zhu
- Department of Laboratory, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China
| | - Zhenquan Yu
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Rong Gao
- Department of Neurosurgery, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China
| | - Huixiang Liu
- Department of Neurosurgery, The First People's Hospital of Zhangjiagang City, Suzhou, Jiangsu, China
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22
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Minlikeeva AN, Freudenheim JL, Cannioto RA, Szender JB, Eng KH, Modugno F, Ness RB, LaMonte MJ, Friel G, Segal BH, Odunsi K, Mayor P, Zsiros E, Schmalfeldt B, Klapdor R, Dӧrk T, Hillemanns P, Kelemen LE, Kӧbel M, Steed H, de Fazio A, Jordan SJ, Nagle CM, Risch HA, Rossing MA, Doherty JA, Goodman MT, Edwards R, Matsuo K, Mizuno M, Karlan BY, Kjær SK, Høgdall E, Jensen A, Schildkraut JM, Terry KL, Cramer DW, Bandera EV, Paddock LE, Kiemeney LA, Massuger LF, Kupryjanczyk J, Berchuck A, Chang-Claude J, Diergaarde B, Webb PM, Moysich KB. History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium. Cancer Causes Control 2017; 28:469-486. [PMID: 28293802 PMCID: PMC5500209 DOI: 10.1007/s10552-017-0867-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/06/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Survival following ovarian cancer diagnosis is generally low; understanding factors related to prognosis could be important to optimize treatment. The role of previously diagnosed comorbidities and use of medications for those conditions in relation to prognosis for ovarian cancer patients has not been studied extensively, particularly according to histological subtype. METHODS Using pooled data from fifteen studies participating in the Ovarian Cancer Association Consortium, we examined the associations between history of hypertension, heart disease, diabetes, and medications taken for these conditions and overall survival (OS) and progression-free survival (PFS) among patients diagnosed with invasive epithelial ovarian carcinoma. We used Cox proportional hazards regression models adjusted for age and stage to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and within strata of histological subtypes. RESULTS History of diabetes was associated with increased risk of mortality (n = 7,674; HR = 1.12; 95% CI = 1.01-1.25). No significant mortality associations were observed for hypertension (n = 6,482; HR = 0.95; 95% CI = 0.88-1.02) or heart disease (n = 4,252; HR = 1.05; 95% CI = 0.87-1.27). No association of these comorbidities was found with PFS in the overall study population. However, among patients with endometrioid tumors, hypertension was associated with lower risk of progression (n = 339, HR = 0.54; 95% CI = 0.35-0.84). Comorbidity was not associated with OS or PFS for any of the other histological subtypes. Ever use of beta blockers, oral antidiabetic medications, and insulin was associated with increased mortality, HR = 1.20; 95% CI = 1.03-1.40, HR = 1.28; 95% CI = 1.05-1.55, and HR = 1.63; 95% CI = 1.20-2.20, respectively. Ever use of diuretics was inversely associated with mortality, HR = 0.71; 95% CI = 0.53-0.94. CONCLUSIONS Histories of hypertension, diabetes, and use of diuretics, beta blockers, insulin, and oral antidiabetic medications may influence the survival of ovarian cancer patients. Understanding mechanisms for these observations could provide insight regarding treatment.
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Affiliation(s)
- Albina N Minlikeeva
- Deparment of Cancer Prevention and Control, Roswell Park Cancer Institute, A-352 Carlton House, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Jo L Freudenheim
- Deparment of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Rikki A Cannioto
- Deparment of Cancer Prevention and Control, Roswell Park Cancer Institute, A-352 Carlton House, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - J Brian Szender
- Department of Surgery, Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Kevin H Eng
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Francesmary Modugno
- Department of Epidemiology, University of Pittsburgh, and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas, School of Public Health, Houston, TX, USA
| | - Michael J LaMonte
- Deparment of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Grace Friel
- Deparment of Cancer Prevention and Control, Roswell Park Cancer Institute, A-352 Carlton House, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Brahm H Segal
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
- Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Kunle Odunsi
- Department of Surgery, Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
- Center of Immunotherapy, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Paul Mayor
- Department of Surgery, Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Emese Zsiros
- Center of Immunotherapy, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Barbara Schmalfeldt
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rüdiger Klapdor
- Department of Obstetrics and Gynecology, Hannover Medical School, Hanover, Lower Saxony, Germany
| | - Thilo Dӧrk
- Department of Obstetrics and Gynecology, Hannover Medical School, Hanover, Lower Saxony, Germany
| | - Peter Hillemanns
- Department of Obstetrics and Gynecology, Hannover Medical School, Hanover, Lower Saxony, Germany
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Martin Kӧbel
- Department of Pathology and Laboratory Medicine, Foothills Medical Center, University of Calgary, Calgary, AB, Canada
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Anna de Fazio
- Department of Gynecological Oncology, Westmead Hospital and the Westmead Millenium Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Susan J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Christina M Nagle
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jennifer A Doherty
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth Medical, Hanover, NH, USA
| | - Marc T Goodman
- Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert Edwards
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Mika Mizuno
- Department of Gynecological Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susanne K Kjær
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Joellen M Schildkraut
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA
| | - Elisa V Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Lisa E Paddock
- New Jersey Department of Health and Senior Services, Trenton, NJ, USA
- School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, USA
| | - Lambertus A Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Leon F Massuger
- Radboud University Medical Center, Radboud Institute for Health Sciences, and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Jolanta Kupryjanczyk
- Department of Pathology and Laboratory Diagnostics, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Brenda Diergaarde
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Kirsten B Moysich
- Deparment of Cancer Prevention and Control, Roswell Park Cancer Institute, A-352 Carlton House, Elm and Carlton Streets, Buffalo, NY, 14263, USA.
- Deparment of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
- Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA.
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23
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Eliopoulos AG, Havaki S, Gorgoulis VG. DNA Damage Response and Autophagy: A Meaningful Partnership. Front Genet 2016; 7:204. [PMID: 27917193 PMCID: PMC5116470 DOI: 10.3389/fgene.2016.00204] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 01/07/2023] Open
Abstract
Autophagy and the DNA damage response (DDR) are biological processes essential for cellular and organismal homeostasis. Herein, we summarize and discuss emerging evidence linking DDR to autophagy. We highlight published data suggesting that autophagy is activated by DNA damage and is required for several functional outcomes of DDR signaling, including repair of DNA lesions, senescence, cell death, and cytokine secretion. Uncovering the mechanisms by which autophagy and DDR are intertwined provides novel insight into the pathobiology of conditions associated with accumulation of DNA damage, including cancer and aging, and novel concepts for the development of improved therapeutic strategies against these pathologies.
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Affiliation(s)
- Aristides G Eliopoulos
- Molecular and Cellular Biology Laboratory, Division of Basic Sciences, Medical School, University of CreteHeraklion, Greece; Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology HellasHeraklion, Greece
| | - Sophia Havaki
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens Athens, Greece
| | - Vassilis G Gorgoulis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Medical School, National and Kapodistrian University of AthensAthens, Greece; Faculty Institute of Cancer Sciences, Manchester Academic Health Sciences Centre, University of ManchesterManchester, UK; Biomedical Research Foundation of the Academy of AthensAthens, Greece
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