ACE Inhibitors May Increase Chances of Breast Cancer Recurrence

A newly published study from researchers at UCLA’s Jonsson Comprehensive Cancer Center indicates that <"">ACE inhibitors may increase the risk that breast cancer survivors will suffer a recurrence. ACE inhibitors are used for controlling blood pressure, treating heart failure, preventing strokes, and preventing kidney damage in people with hypertension or diabetes. Some common ACE inhibitors include: Benazepril (Lotensin), Captopril, Enalapril (Vasotec), Fosinopril, Lisinopril (Prinivil, Zestril), Moexipril (Univasc), Perindopril (Aceon), Quinapril (Accupril), Ramipril (Altace) and Trandolapril (Mavik).

The same study also found that a different class of drugs called beta blockers may help prevent breast cancer recurrence. Beta blockers are used to control high blood pressure and cardiac arrhythmias. This class of medications includes the drugs Propranolol (Inderal), Metoprolol (Lopressor, Toprol XL), Pindolol (Visken), Labetalol (Normodyne, Trandate) and Carvedilol (Coreg).

According to a press release from UCLA, this new study involved a retrospective analysis done using data from the Life After Cancer Epidemiology (LACE) study, which includes 1,779 women diagnosed with early stage breast cancer. The study included patients who were followed for an average of eight years, and for whom pharmacy data on the use of various medications was available. Information about cancer stage, treatments and other chronic conditions also was available.

Of the 1,779 women included in the study, 23 percent were exposed to either a beta blocker or an ACE inhibitor. The women taking these drugs were generally older, post-menopausal and had other health issues, such as being overweight and having hypertension or diabetes.

A total of 292 women experienced a breast cancer recurrence. The women exposed to ACE inhibitors had a significantly increased risk for recurrence, while those on beta blockers alone had a lower risk of recurrence. Exposure to both beta blockers and ACE inhibitors had an intermediate risk for recurrence, suggesting that the beta blockers might modify the increased risk associated with ACE inhibitor therapy.

“The ACE inhibitor findings were not expected. These observations need to be confirmed and suggest that greater attention should be focused on the potential effect of these commonly used medications on recurrence and breast cancer survival,” Dr. Patricia Ganz, director of cancer prevention and control research at UCLA’s Jonsson Cancer Center and first author of the study, said in the UCLA press release.

According to the statement, Ganz currently is working with researchers in Denmark and Canada to examine these same medications and their relationship to recurrence in much larger samples of breast cancer patients. She hopes to confirm the findings in this study within the next year to have a clearer picture of the effects of beta blockers and ACE inhibitors on the risk for recurrence. If beta blockers do prove to be protective in these additional studies, it may lead to prevention trials in women at high risk for recurrence, such as those treated for triple negative breast cancer, for which few effective therapies exist beyond chemotherapy.

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