The impact of peroxisome proliferator-activated receptor-γ activating angiotensin receptor blocker on outcomes of patients receiving immunotherapy

Background: Certain angiotensin receptor blockers (ARBs) have peroxisome proliferator-activated receptor-gamma (PPAR-gamma) activation property, which has been associated with improved programmed cell death ligand 1 blockade and cytotoxic T lymphocyte-mediated antitumor activity.Methods: We conducted a retrospective cohort study to investigate the impact of PPAR-gamma-activating ARBs on patient survival in patients treated with immune checkpoint inhibitors (ICIs) across all types of cancers.Results: A total of 167 patients receiving both angiotensin receptor blockers (ARBs) and immune checkpoint inhibitors (ICIs) were included. Compared with non- PPAR-gamma-ARB users (n = 102), PPAR-gamma-ARB users (n = 65) had a longer median overall survival (not reached [IQR, 16.0 & mdash;not reached] vs. 18.6 [IQR, 6.1- 38.6] months) and progression-free survival (17.3 [IQR, 5.1 & mdash;not reached] vs. 8.2 [IQR, 2.4- 18.6] months). In Cox regression analysis, the use of PPAR-gamma-activating ARBs had an approximately 50% reduction in all-cause mortality and disease pro-gression. Patients who received PPAR-gamma-activating ARBs also had higher clinical benefit rates than non- PPAR-gamma-ARB users (82% vs. 61%, p = 0.005).Conclusion: The use of ARBs with PPAR-gamma-activating property is linked with better survival among patients receiving ICIs.

Automated summary

This retrospective cohort study investigated the impact of PPAR-gamma-activating ARBs on the survival of patients treated with immune checkpoint inhibitors (ICIs). The results showed that patients who used PPAR-gamma-activating ARBs had longer overall survival and progression-free survival, as well as lower disease progression and overall mortality rates compared to non-PPAR-gamma-ARB users. Patients who received PPAR-gamma-activating ARBs also had a higher clinical benefit rate.