slow accrual

RATIONALE: Benazepril hydrochloride, lisinopril, ramipril, and losartan potassium may help lower blood pressure.

PURPOSE: This phase II trial is studying how well benazepril hydrochloride, lisinopril, ramipril, or losartan potassium works in treating hypertension in patients with solid tumors.

PRIMARY OBJECTIVES:

I. To determine which drug has the greatest effect on Ang-(1-7) levels in cancer patients with hypertension.

SECONDARY OBJECTIVES:

I. To determine the effect of these drugs on levels of Ang II, VEGF, PlGF, and ACE in the same patients.

OUTLINE: Patients are randomized to 1 of 4 treatment arms.

• ARM I: Patients receive oral benazepril hydrochloride once daily on days 1-7.
• ARM II: Patients receive oral lisinopril once daily on days 1-7.
• ARM III: Patients receive oral ramipril twice daily on days 1-7.
• ARM IV: Patients receive oral losartan potassium once daily on days 1-7. In all arms, treatment continues in the absence of unacceptable toxicity.

Inclusion Criteria:

• Patients must have histologically or cytologically confirmed solid tumor malignancy AND hypertension, defined as a systolic pressure > 130 OR a diastolic pressure > 80
• Patients cannot be on active chemotherapy or radiation therapy; start of treatment with ACE-I or ARB must occur at least four weeks after the last dose of chemotherapy or radiation therapy
• Creatinine < 2.5
• Potassium < ULN
• Ability to understand and the willingness to sign a written informed consent document
• HIV positive patients are eligible to participate in this study

Exclusion Criteria:

• Patients who are pregnant or nursing due to significant risk to the fetus/infant
• Patients who are unable to take oral medications
• Patients who are currently taking an ACE-Inhibitor or ARB