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Sartan use may improve OS for HCC

Researchers in Italy found that the use of angiotensin II type 1 receptor blockers known as sartans improved overall survival and delayed time to recurrence for patients with hepatocellular carcinoma, according to published findings.

“Our study is the first report on the efficacy of sartans in increasing [radiofrequency ablation] and OS rates in HCC patients after radical therapy,” Antonio Facciorusso, MD, department of medical sciences, University of Foggia, Italy, and colleagues wrote.

The researchers analyzed data of 153 patients with HCC who underwent percutaneous radiofrequency ablation (RFA) and treated for first occurrence of neoplasia. These patients were classified them into three groups: patients who received neither angiotensin-converting enzyme inhibitors nor sartans (n = 73); patients treated with angiotensin-converting enzyme inhibitors (n = 49); and patients treated with sartans (n = 31). Kaplan-Meier analysis was used to measure survival outcomes and compared them with log-rank test.

Antonio Facciorusso

“Data on the chemoprevention effect against HCC recurrence of angiotensin II type 1 receptor blockers, such as sartans, are still lacking. …The aim of this study was to evaluate whether angiotensin II receptor 1 blockers can delay time to recurrence and prolong OS when used in HCC patients after treatment with percutaneous RFA,” the researchers wrote.

Analyses indicated that the median OS was 48 months (95% CI, 31-58) among patients who did not receive angiotensin-converting enzyme inhibitors or sartans, 72 months (95% CI, 49-89) among patients treated with angiotensin-converting enzyme inhibitors and 84 months (95% CI, 58-92) among patients treated with sartans (P = .02).

The median time to recurrence was shortest in patients who did not receive angiotensin-converting enzyme inhibitors or sartans (n = 26 months; 95% CI, 15-42) compared with patients treated with angiotensin-converting enzyme inhibitors (n = 44 months; 95% CI, 33-72) and patients treated with sartans (n = 69 months; 95% CI, 44-74).

Of the patients, 99 experienced tumor recurrence, with a median time to recurrence of 42 months. The recurrence-free survival rate was 80% at 1 year, 40.9% at 4 years and 37% at 5 years.

Multivariate analysis showed sartan therapy to be a predictor of greater overall survival and delayed time to recurrence.

The researchers concluded: “We … think that due to their low cost and easy use, sartans may represent a promising therapeutic tool in the management of early HCC patients undergoing ablative or surgical therapies.” – by Melinda Stevens

Disclosures: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.