The Concomitant Use of Angiotensin System Inhibitors Predicts Favorable Prognosis for Renal Cell Carcinoma Patients

Objective Previous data suggest that Angiotensin system inhibitors (ASIs) may exert antitumor effects; however, the findings remain controversial. Therefore, the present study was conducted to evaluate the association between concomitant use of ASIs and survival outcomes in patients with renal cell carcinoma (RCC). Methods We conducted a comprehensive search of electronic databases, including PubMed and Web of Science, to identify relevant studies according to the predefined inclusion and exclusion criteria. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models, as appropriate. Results Favourable overall survival (OS) was observed in patients using ASIs compared with non-users (hazard ratio [HR] = 0.68, 95% CI: 0.57–0.81; p = 0.000). In the subgroup analysis, OS benefits were evident across treatment agents, the time window of ASI use, and in patients with metastatic renal cell carcinoma (mRCC). Moreover, progression-free survival (PFS) and disease-specific survival (DSS) benefits were observed in ASI users compared to non-users (HR = 0.74, 95% CI: 0.62–0.87; p = 0.000). Additionally, consistent DSS and PFS advantages were noted across treatment agents, mRCC, and the time window for ASI use. Conclusion Our findings indicate that concomitant use of ASIs is significantly associated with improved survival outcomes in patients with RCC. Further high-quality studies are required to validate these conclusions.