Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.

If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.

This week’s study is…

Angiotensin blockade therapy and survival in pancreatic cancer: a population study

We previously published about this research in a story titled “Study Suggests that Hypertension Medicine Could Improve Pancreatic Cancer Survival” which can be found here. The study was originally published in the journal BMC Cancer. You can view the full text of the study here.

This research team was affiliated with Thomas Jefferson University.

What Happened?

Pancreatic cancer is one of the most deadly cancers, with late diagnosis and a low rate of long term survival. In fact, some patients die within a year of getting diagnosed. With this dire state of affairs, scientists are desperately looking for ways to improve survival and treatment of this aggressive disease. It is the fourth leading cause of cancer death in the US. In this study, scientists conducted a population study to evaluate whether angiotensin blocking therapies, such as angiotensin II receptor blockers (ARBs) and angiotensin I converting enzyme (ACE) inhibitors, have any impact on survival. This was based on some earlier studies which have suggested that these sorts of therapies could slow the growth of pancreatic cancer.

The study included a total of 8,158 patients drawn from the database of the Emilia-Romagna Region of northern Italy. These patients were from the time range of 2003-2011. 36 percent has been diagnosed with metastatic cancer, 20 percent had been treated with surgery, and 86 percent were dead by December 2012. The researchers then identified which patients had been using ACE inhibitors and ARBs. 

The scientists found that patients using ACE inhibitors during the first three years following their cancer diagnosis had a 13 percent lower risk of mortality (death) compared to the overall patient sample. Meanwhile, patients using ARBs after diagnosis has a risk of mortality that was 20 percent lower. In patients treated with surgery, the ARBs reduced mortality risk by 28 percent. Overall, the researchers conclude that these findings suggest that use of ACE inhibitors and ARBs is associated with improved survival times for pancreatic cancer patients. 

About Pancreatic Cancer

Pancreatic cancer is one of the most dangerous forms of cancer. The disease affects the pancreas, which is a glandular organ that is situated behind the stomach. Part of the reason that pancreatic cancer is so dangerous is that it rarely produces noticeable symptoms until it has reached an advanced stage and begun to spread. However, even when detected earlier, it is difficult to treat effectively. Risk factors for pancreatic cancer include being male, old age, African-American ancestry, family history, smoking, obesity, diabetes, chronic pancreatitis, and a diet heavy in red meat, processed meat, or meat cooked at very high temperatures. Symptoms include depression, upper abdominal pain, jaundice, diabetes, constipation, weight loss, and appetite loss. Treatment approaches for this cancer include surgery, chemotherapy, and radiation therapy. Even with heavy treatment, pancreatic cancer almost always returns. The five year survival rate is just ten percent. To learn more about pancreatic cancer, click here.

Why Does it Matter?

Outcomes for pancreatic cancer are very poor, with most patients dying relatively quickly of their disease when compared to other cancers. This is partially due to the cancer often being diagnosed at a late stage, when surgical resection, the most effective approach that can significantly prolong survival, is no longer effective. Advances in early diagnosis and treating advanced disease have not progressed much in recent decades, so the discovery of medicines that have a positive effect on survival is major news.

ACE inhibitors and ARBs also have the benefit of being widely available and relatively inexpensive, plus they are already widely approved for public use by regulatory agencies like the US Food and Drug Administration (FDA). This is a major advantage when compared to the time and cost required to develop an all new treatment.

“These medications for hypertension do not have a lot of side effects – far fewer than chemotherapy, for example – and yet our data suggests that they might extend life in patients with pancreatic cancer.”  – Scott W. Keith, PhD., associate professor of Biostatistics, Thomas Jefferson University

The next step in researching this matter with involve a controlled clinical study to test the effects of ARBs and ACE inhibitors in pancreatic cancer patients directly.