{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:38:07Z","timestamp":1777876687727,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010101","name":"taichung veterans general hospital","doi-asserted-by":"publisher","award":["1128605"],"award-info":[{"award-number":["1128605"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma (PDAC) necessitates the exploration of novel strategies to overcome treatment resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to investigate the impact of combining renin\u2013angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Patients with PDAC were enrolled in the retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed patients with PDAC ( n\u2009=\u2009384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI\/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p\u2009=\u20090.008) compared to the non-ACEI\/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI\/ARB was associated with better 12-month EFS (hazards ratio\u2009=\u20090.71, 95% confidence interval: 0.52\u20130.96; p\u2009=\u20090.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Concomitant use of ACEIs\/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359241247019","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T08:31:16Z","timestamp":1714984276000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The concomitant use of the renin\u2013angiotensin system inhibitors and survival outcomes of patients with pancreatic adenocarcinoma: an analysis from a tertiary center"],"prefix":"10.1177","volume":"16","author":[{"given":"Kuan-Yu","family":"Tseng","sequence":"first","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiann-Yi","family":"Hsu","sequence":"additional","affiliation":[{"name":"Biostatistics Task Force, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hsuan","family":"Shih","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan"},{"name":"Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin-Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"You-Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Chiayi Branch, Taichung Veterans General Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-0368","authenticated-orcid":false,"given":"Chieh-Lin","family":"Jerry Teng","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan"},{"name":"Department of Life Science, Tunghai University, Taichung, Taiwan"},{"name":"School of Medicine, Chung Shan Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-4964","authenticated-orcid":false,"given":"Cheng-Wei","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung 40705, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan"},{"name":"Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"bibr1-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-021-00457-x"},{"key":"bibr2-17588359241247019","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i43.4846"},{"key":"bibr3-17588359241247019","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2017.12.04"},{"key":"bibr4-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13027"},{"key":"bibr5-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30974-0"},{"key":"bibr6-17588359241247019","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20184504"},{"key":"bibr7-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1177\/1753944716644130"},{"key":"bibr8-17588359241247019","first-page":"884","volume":"11","author":"Yang J","year":"2021","journal-title":"Am J Cancer Res"},{"key":"bibr9-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2021.119118"},{"key":"bibr10-17588359241247019","doi-asserted-by":"publisher","DOI":"10.2174\/156800911795538110"},{"key":"bibr11-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms3516"},{"key":"bibr12-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-022-01038-4"},{"key":"bibr13-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-09200-4"},{"key":"bibr14-17588359241247019","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-3-200902030-00011"},{"key":"bibr15-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605955"},{"key":"bibr16-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-0256"},{"key":"bibr17-17588359241247019","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13205086"},{"key":"bibr18-17588359241247019","doi-asserted-by":"publisher","DOI":"10.3390\/jcm6010005"},{"key":"bibr19-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1007\/s13277-014-2883-z"},{"key":"bibr20-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-84787-5"},{"key":"bibr21-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aan5616"},{"key":"bibr22-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2011.03.011"},{"key":"bibr23-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.03.418"},{"key":"bibr24-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.9007"},{"key":"bibr25-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0901557"},{"key":"bibr26-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1152"},{"key":"bibr27-17588359241247019","volume":"99","author":"Li SS","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"bibr28-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1809775"},{"key":"bibr29-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011923"},{"key":"bibr30-17588359241247019","volume":"31","author":"Hoff DDV","year":"2013","journal-title":"J Clin Oncol"},{"key":"bibr31-17588359241247019","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.12.007"}],"container-title":["Therapeutic Advances in Medical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359241247019","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17588359241247019","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359241247019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:29:57Z","timestamp":1777588197000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17588359241247019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":31,"alternative-id":["10.1177\/17588359241247019"],"URL":"https:\/\/doi.org\/10.1177\/17588359241247019","relation":{},"ISSN":["1758-8359","1758-8359"],"issn-type":[{"value":"1758-8359","type":"print"},{"value":"1758-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"17588359241247019"}}