2026-10-14T08:39:33Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33949915 2026-09-21T05:36:32Z category_19 portal_316 item_type_3 month_year_09_2026

Table 1_Renin–angiotensin system inhibitor use and survival outcomes in lung cancer: a systematic review and meta-analysis.docx Yongqian Liao (25080481) Jinhai Shen (1446184) Yonghe Liao (20681697) Yuxuan Lin (1370199) Nengyong Zeng (25080484) Pharmacology lung cancer meta-analysis overall survival progression-free survival renin-angiotensin system inhibitors Background<p>Renin-angiotensin system inhibitors (RASi) have been associated with favorable survival outcomes across various cancers, but their association with survival in lung cancer remains uncertain. We conducted a systematic review and meta-analysis to evaluate the association between RASi use and survival outcomes in patients with lung cancer.</p>Methods<p>PubMed and Embase were searched from inception to 6 July 2026. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup and sensitivity analyses, including large-study restricted analysis and precision-effect test and precision-effect estimate with standard error (PET-PEESE) regression, were performed to explore heterogeneity and assess the potential influence of small-study effects.</p>Results<p>Twenty-six studies involving 403,423 patients were included. RASi use was associated with longer overall survival (OS; HR = 0.76, 95% CI: 0.70–0.83; I² = 82.9%) and progression-free survival (PFS; HR = 0.79, 95% CI: 0.70–0.89; I² = 40.9%) in conventional random-effects meta-analyses. Subgroup analyses generally showed consistent associations across treatment modalities and geographic regions, although substantial heterogeneity remained in several subgroups. Egger’s test indicated small-study effects for OS. Although the large-study restricted analysis remained significant (HR = 0.82, 95% CI: 0.74–0.90), PET-PEESE adjustment attenuated the estimate to the null (HR = 1.00, 95% CI: 0.95–1.05). No significant evidence of small-study effects was observed for PFS.</p>Conclusion<p>Conventional meta-analysis showed an association between RASi use and longer OS and PFS. However, the OS association was attenuated to the null after adjustment for small-study effects, indicating that the magnitude and robustness of the observed OS association remain uncertain. These findings should therefore be interpreted cautiously and require confirmation in well-designed prospective studies.</p>Systematic Review Registration<p>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251053671, identifier: CRD420251053671.</p> 2026-09-21T05:36:32Z Dataset Dataset 10.3389/fphar.2026.1953204.s001 https://figshare.com/articles/dataset/Table_1_Renin_angiotensin_system_inhibitor_use_and_survival_outcomes_in_lung_cancer_a_systematic_review_and_meta-analysis_docx/33949915 CC BY 4.0