High blood pressure is strongly correlated to cancer. This risk factor, among others including smoking, obesity, and inactivity, cause deleterious effects to the body. Interestingly, high blood pressure and cancer affect each other in a bidirectional manner. Not only does high blood pressure increase your risk of cancer, but cancer can also raise your blood pressure, causing hypertension. Additionally, many cancer treatments increase blood pressure – such as targeted agents and steroids – and require careful monitoring. As a result, patients are at risk for cardiovascular disease and other associated health problems.
Hypertension can affect different organs since the body needs to work harder to pump blood through the system. Since cancer treatments can raise blood pressure, risk of fatal illness increases with a likelihood of heart attack, irregular heartbeat, and kidney damage. Strategies to avoid hypertension include lifestyle changes, such as weight loss, exercise, and a low-sodium diet. Medication is commonly prescribed if the patient has other risk factors of disease or blood pressure readings do not go down after proper lifestyle changes. Scientists are currently working on ways to better treat cancer patients with other comorbidities, including high blood pressure.
A recent article in the Journal for ImmunoTherapy of Cancer (JITC), by Dr. Tyler Curiel and others, demonstrated how a blood pressure medication can enhance cancer treatment. This work helps improve cancer care in patients and has the potential to control high blood pressure in patients receiving tumor immunotherapy. Curiel is Professor of Medicine Oncology, and Microbiology and Immunology at Dartmouth College Geisel School of Medicine. Curiel’s work focuses on immunotherapy for the treatment of solid tumors. Specifically, he studies immune cells and how to better boost their antitumor activity.
Researchers found that an U.S. Food and Drug Administration (FDA)-approved blood pressure medication – telmisartan – enhances immune cell activity. Curiel and his lab observed increased cancer-killing when telmisartan was administered with Olaparib – a Poly (ADP-ribose) polymerase (PARP) inhibitor. Physicians commonly prescribed PARP inhibitors to treat patients with breast cancer because they specifically destroy cancer cells with BRCA1/2 mutations by disrupting DNA repair. Unfortunately, tumors can adapt and become resistant to PARP inhibitors. However, this novel drug combination works well because telmisartan sensitizes solid treatment-resistant tumors to PARP inhibitors. Consequently, combining both drugs significantly improves antitumor immunity.
Scientists used various laboratory techniques to demonstrate the efficacy of this combination therapy. Telmisartan was found to increased DNA damage in tumor cells as Olaparib increased immune cell response. Specifically, Olaparib boosts proteins and molecules that drive antitumor activity. A large benefit to using these drugs includes that fact that they are both safe and used in the clinic. Currently, two clinical trials are occurring at Dartmouth for metastatic, castration-resistant prostate cancer and platinum-resistant ovarian cancer. Scientists hope to finish these clinical trials and understand more about this combination approach in patients with resistance to standard-of-care treatment.
Scientists discovered that blood pressure medication, telmisartan, can improve cytotoxic effects on the tumor using Olaparib. This study demonstrates a safe, tolerable, and inexpensive therapy combination that enhances current cancer treatment. Overall, these findings help better inform current treatment strategies for solid tumors and improve patient survival.
Article, JITC, Tyler Curiel, Dartmouth College Geisel School of Medicine
