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Updated: Jan 19, 2026
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
Renin-Angiotensin Inhibition in Combating Malignancy: A Review
Talma Rosenthal1, Irene Gavras2
1Department of Physiology and Pharmacology, Hypertension Research Unit, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel rtalma@tauex.tau.ac.il.
Abstract:
Our previous review of the literature assessed the existing knowledge (until 2000) about the possible link between angiotensin-converting enzyme inhibitors (ACEIs) and factors influencing the development of malignancies. We reviewed the literature for reports of statistical associations (or lack thereof) between ACEi treatment and incidence of specific cancers (e.g. breast, gastrointestinal, and skin). We concluded then that results from the epidemiological studies are conflicting, even taking the different methodology and endpoints into consideration, and thus inconclusive. Further investigation is needed beyond the observation period of most of these studies, and additional experimental studies are needed also to study the mechanisms by which agents blocking the renin-angiotensin system may obtain their inhibitory effect on tumor growth and metastasis. The present review elaborates further with more recent evidence from numerous human clinical studies from the past two decades (including large epidemiological studies, and long-term prospective and retrospective studies) on a protective association between ACEi treatment and the prognosis of patients with specific cancer types, malignancy characteristics or stage. Moreover, treatment with ACEI/angiotensin receptor blockers represents an adjuvant therapy with synergistic effects to chemotherapy and may improve patient outcomes (i.e. progression-free survival, and prolonged overall survival) in different types of cancers.
Insights
Angiotensin-converting enzyme inhibitors (ACEIs) show a protective association with cancer prognosis and may improve outcomes when used with chemotherapy. Further research is needed to understand their anti-tumor mechanisms.
Area of Science:
- Oncology
- Pharmacology
- Epidemiology
Background:
- Previous literature reviews until 2000 found conflicting evidence on the link between ACEIs and cancer development.
- Inconclusive results necessitated further investigation into ACEIs' potential role in malignancy.
- Experimental studies were needed to elucidate the mechanisms of renin-angiotensin system blockers on tumor growth.
Purpose of the Study:
- To review recent human clinical studies from the past two decades on ACEI treatment and cancer prognosis.
- To evaluate the protective association between ACEI treatment and patient outcomes in various cancer types.
- To assess the role of ACEI/angiotensin receptor blockers as adjuvant therapy in cancer treatment.
Main Methods:
- Comprehensive review of human clinical studies, including large epidemiological, prospective, and retrospective studies.
- Analysis of data from the past 20 years focusing on ACEI treatment and cancer incidence, prognosis, and survival.
- Evaluation of synergistic effects of ACEI/angiotensin receptor blockers with chemotherapy.
Main Results:
- Recent evidence suggests a protective association between ACEI treatment and the prognosis of patients with specific cancer types.
- ACEI treatment correlates with improved patient outcomes, including progression-free and overall survival.
- ACEI/angiotensin receptor blockers demonstrate synergistic effects when used as adjuvant therapy with chemotherapy.
Conclusions:
- ACEI treatment is associated with a protective effect on cancer prognosis across various cancer types and stages.
- Combined therapy with ACEI/angiotensin receptor blockers and chemotherapy may enhance patient outcomes.
- Further research into the anti-tumor mechanisms of ACEIs warrants continued investigation.
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