Could Common Blood Pressure Meds Help Curb Pancreatic Cancer?
Pancreatic cancer is notoriously difficult to treat and beat, but new research suggests that commonly prescribed high blood pressure drugs may boost survival in patients.
Known as angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs), those who took them saw slight bumps in survival.
Folks with pancreatic cancer who took an ARB had a 20% lower risk of dying during the study period, and those taking ACE inhibitors saw a 13% reduction in their risk of dying when compared to people with the cancer who were not taking these blood pressure medications.
"We don't see results that are a whole lot better with chemotherapy for pancreatic cancer," said study author Scott Keith, an associate professor of biostatistics at Thomas Jefferson University in Philadelphia. "These are inexpensive medications, have a low side-effect profile, are widely available, and very well could improve survival of people with pancreatic cancer."
Despite this promise, the study authors and other experts caution that it's way too early to suggest that all people with pancreatic cancer start taking these medications in hopes of gaining a survival edge.
The new study wasn't designed to say how, or even if, these drugs improve survival. "In vitro and in vivo studies have suggested that these drugs may improve the way chemotherapy works or change the way that tumors are constructed to slow their growth," Keith said.
More research is still needed to understand any potential mechanisms.
Study author Vittorio Maio added, "We have to have real evidence that something works one way or the another, and we can't prove that these medications have a really substantial effect yet, so it's not prudent to make recommendations that will create false hope for patients." Maio is the managing director of the Asano-Gonnella Center for Research in Medical Education and Health Care at Thomas Jefferson University.
For the study, the research team tapped into a database of 3.7 million people in northern Italy that included more than 8,150 people with pancreatic cancer. Close to half of the patients with pancreatic cancer were also taking ACE inhibitors or ARBs to control high blood pressure.
About 86% of the people with pancreatic cancer died within 6.4 months of their diagnosis. Folks taking blood pressure medications lived longer than those who weren't, the study found. The lower risk associated with ACE inhibitors diminished after three years, while the lower risk associated with ARBs remained.
What's more, the risk reduction seen in people taking ARBs was even greater if they also had surgery for their cancer, the study showed.
Now it's time for a large-scale trial where some people with pancreatic cancer take ACE inhibitors or ARBs and others take a placebo or dummy pill, the researchers suggested.
"We need to get to a point where we have more than just a signal, but can provide a really firm estimate of how long pancreatic cancer patients will survive, on average, versus people who don't take these medications," Maio said.
There is a tremendous need for more effective treatments for people with pancreatic cancer, he noted.
Unless pancreatic cancer is caught early, just about 10% of people will survive for five years. It's rarely caught early as symptoms are vague, and the pancreas is located deep in the abdomen, where it can't easily be seen or felt during an exam. Surgery offers a fighting chance, but most people are diagnosed with pancreatic cancer when it's in its later stages and surgery is no longer an option.
The study was published online recently in the journal BMC Cancer.
Experts who were not involved with the new research agreed that more study is needed before suggesting people with pancreatic cancer start taking blood pressure pills.
"This is an interesting paper that needs further validation," said Dr. Aaron Sasson, director of the Pancreatic Cancer Center at Stony Brook Medicine in New York.
There's been lots of false hope peddled to people with pancreatic cancer in the past, and it's important not to oversell any potential therapy, he said. "We are making progress, but this is still a very deadly disease." That said, if you have pancreatic cancer and high blood pressure, talk to your doctor about these medications, Sasson added.
"There's no reason not to try it if you need an antihypertensive drug and also have pancreatic cancer," Sasson said.
Dr. Timothy Donahue, chief of surgical oncology at UCLA's Jonsson Comprehensive Cancer Center, added, "The data so far are correlative, and they would still be considered experimental agents. I would prioritize the medications that have been proven successful in prospective randomized studies."
The Pancreatic Cancer Action Network has more on pancreatic cancer.
SOURCES: Scott Keith, PhD, associate professor, biostatistics, Thomas Jefferson University, Philadelphia; Vittorio Maio, managing director, Asano-Gonnella Center for Research in Medical Education and Health Care, Thomas Jefferson University, Philadelphia; Aaron Sasson, MD, director, Pancreatic Cancer Center, Stony Brook Medicine, New York; Timothy Donahue, MD, chief, surgical oncology, UCLA Jonsson Comprehensive Cancer Center; BMC Cancer, Feb. 7, 2022, online