This is a new paper (click here for abstract) brought to us by some of the same authors who earlier produced:
Does Valproic Acid or Levetiracetam Improve Survival in Glioblastoma? A Pooled Analysis of Prospective Clinical Trials in Newly Diagnosed Glioblastoma
The group concluded:
"This secondary analysis of two large glioblastoma trials thus was unable to detect evidence for an association of the use of statins, ACEI or sartans with outcome in patients with newly diagnosed glioblastoma."
As with the previous study, there are some important caveats. Some of the most intriguing data supporting the potential for angiotensin system blockers was in combination with bevacizumab:
Effect of angiotensin system inhibitors on survival in newly diagnosed glioma patients and recurrent glioblastoma patients receiving chemotherapy and/or bevacizumab
It would have been interesting to look at outcomes in those using/not using ACE inhibitors or sartans in combination with bevacizumab, for example in the Avaglio and RTOG-0825 trials.
Angiotensin-II has been shown to increase tumor-promoting macrophages in preclinical models:
https://www.ncbi.nlm.nih.gov/pubmed/23333075
and these tumor-infiltrating myeloid cells may play a significant role in resistance to anti-VEGF therapies such as bevacizumab.
https://www.ncbi.nlm.nih.gov/pubmed/26404753
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