Effect of initiating antihypertensive regimens associated with chemotherapy on pancreatic, colorectal and ovarian cancer outcomes: a Medicare SEER cohort analysis

• Grant number: 22/01243-3
• Support type: Scholarships abroad - Research Internship - Scientific Initiation
• Effective date (Start): August 01, 2022
• Effective date (End): August 31, 2022
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal researcher: Roger Chammas
• Grantee: Lucas Evaristo Ferreira Flausino
• Supervisor abroad: Rajesh Balkrishnan
• Home Institution: Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (ICESP). Coordenadoria de Serviços de Saúde (CSS). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Research place: University of Virginia (UVa), United States
• Associated to the scholarship: 20/15317-3 - Exercise as a strategy to shift activation of tumor-associated macrophages, BP.IC

Abstract

Colorectal and pancreatic cancer are among the five leading causes of cancer death in all ages, in the United States, including ovarian cancer in the case of female patients. In common, these tumors have a large amount of extracellular matrix and interstitial fibrosis. These features, associated with aberrant vascularization and poor lymphatic drainage, increase tumor interstitial fluid pressure (IFP). This increment on IFP plus the solid stress, created by the stiffened matrix, decreases the nutrients and oxygen diffusion, resulting in hypoxia and high cancer cells proliferation. Moreover, these features spoil the efficient delivery of drugs and immune cells to the tumor, promoting worse clinical outcomes.Arterial hypertension is one of the most common comorbidities in cancer patients, and increasing literature data is supporting that, in addition to controlling blood pressure, antihypertensive drugs can interfere with the tumor microenvironment, in terms of fibrosis production, proliferation rates, inflammation, and vascular function. By doing so, these drugs could enhance better drug delivery and action on the tumor microenvironment, improving patient outcomes. Thus, this project intends to assess the association between initiating antihypertensive regimens and chemotherapy on colorectal, pancreatic, and ovarian cancer outcomes, through a non-interventional, retrospective analysis in the Surveillance, Epidemiology, and End-Results (SEER)-Medicare database. (AU)