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Risk of lung cancer and renin-angiotensin blockade: a concise review

Tobias Rachow1, Helmut Schiffl2, Susanne M Lang3

  • 1Klinik Für Innere Medizin II, Sektion Pneumologische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany. tobias.rachow@med.uni-jena.de.

Journal of Cancer Research and Clinical Oncology
|November 24, 2020
PubMed
Abstract

Insights

Renin-angiotensin-aldosterone system (RAAS) blockers are commonly used for hypertension and heart failure. Current evidence suggests RAAS blockers do not increase lung cancer risk and may benefit non-small cell lung cancer treatment.

Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Renin-angiotensin-aldosterone system (RAAS) blockers, including ACE inhibitors and ARBs, are widely prescribed for hypertension, heart failure, and renal diseases.
  • Concerns exist regarding a potential association between RAAS blockers and an increased risk of cancer, particularly lung cancer.

Purpose of the Study:

  • To critically appraise the existing evidence on the link between RAAS blockade and de novo lung cancer development.
  • To guide physicians in understanding the potential relationship between these common medications and lung cancer risk.

Main Methods:

  • Review of numerous pharmaco-epidemiologic studies, primarily retrospective cohort analyses.
  • Analysis of meta-analyses that evaluated the association between RAAS blockade and lung cancer incidence.

Main Results:

  • International regulatory agencies (FDA, EMA) have concluded no association between RAAS blockers and increased lung cancer risk.
  • Co-administration of RAAS blockers with systemic therapy for advanced non-small cell lung cancer may improve patient outcomes.

Conclusions:

  • Current clinical practice regarding RAAS blocker use does not require modification.
  • Further prospective randomized trials with long-term follow-up are necessary to definitively assess the impact of RAAS blockers on lung cancer development and progression.
Keywords:
Angiotensin enzyme inhibitorsAngiotensin receptor blockersNon-small cell lung cancerRenin–angiotensin–aldosterone system

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