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Potency-enhancing may decrease risks in men with CRC

Mon, 08/17/2020 - 17:54
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Protective effect was even stronger in men who used these drugs after receiving open surgery

A study from Lund University and Region Skåne in Sweden indicates that potency-enhancing PDE5 inhibitor drugs have an anti-cancer potential with the ability to improve the prognosis in patients with colorectal cancer. PDE5 inhibitors include a few approved drugs in which sildenafil (Viagra) is the most well-known. The study, ‘Phosphodiesterase-5 inhibitors use and risk for mortality and metastases among male patients with colorectal cancer’, was published in Nature Communications

"Available preclinical evidence suggests that PDE5 inhibitors could slow down the tumour growth and progression in mice, but it is still unknown whether PDE5 inhibitors can hinder the proliferation of cancer in humans,” explained Wuqing Huang, a PhD student at Lund University and one of the researchers behind the study. “We tried to explore this using real-world medical data in Sweden."

By linking several nationwide registers, Wuqing Huang identified all Swedish male patients with colorectal cancer who had used PDE5 inhibitors after their cancer diagnosis (n=1,136 patients). During the follow-up period, around 10.2% of patients had died from colorectal cancer among those who used PDE5 inhibitors after diagnosis, whereas the probability was 17.5% in patients who did not use PDE5 inhibitors (n=11,329). After consideration of a range of clinical confounding factors, the relative risk of death caused by colorectal cancer was 18% lower among patients who used the drugs. The risk of metastases, especially distant metastases which is the main cause of death due to cancer, was also lower among patients who used PDE5 inhibitors.

"In addition, the protective effect was even stronger in men who used these drugs after receiving open surgery,” added Huang. “This finding provides the first-ever human-based evidence in terms of the anti-tumour effect of PDE5 inhibitors on colorectal cancer, which complements the preclinical evidence."

One of the mechanisms that has been suggested to be a critical process that leads to adverse outcomes among patients with cancer post-surgery, is surgery-induced immune suppression.

"The results of our study suggest that the anti-cancer ability of PDE5 inhibitors might be related to regulating immunosuppressive effects. However, randomised clinical trials are needed to confirm our research findings before PDE5 inhibitors can be used as an adjuvant drug for men with colorectal cancer, as well as experiments that explore the underlying biological mechanisms," she said.

"The observed findings should be interpreted with caution as this is an observational study and the biological mechanisms need to be explored further,” concluded Jianguang Ji, a researcher at Lund University involved in the study. “We have already collaborated with other scientists to explore the underlying mechanisms by utilising animal experiments and cancer organoid."

To access this paper, please click here