Leukotriene receptor antagonist drugs as potential chemopreventive agents: A systematic review and meta-analysis of cancer risk in asthmatic patients.

Inflammation represents a critical factor in carcinogenesis, and cysteinyl leukotrienes (CysLTs) have been associated with tumor development and progression. Thus, it has been hypothesized that leukotriene receptor antagonists (LTRAs), widely used in the treatment of asthma, could exert a chemopreventive effect due to the modulation of inflammatory pathways. However, the association between LTRAs and cancer risk among asthma patients is still not fully understood. Medline, Scopus, Web of Science, and the Cochrane Library were searched from inception to August 2, 2025 for studies including patients with asthma that have used LTRAs reporting cancer risk. Statistical analysis was made in R software, with hazard outcomes using hazard ratio (HR) by applying Inverse variance random-effect models. P values <0.05 were set as statistical significance. Five studies involving 281,420 individuals, of which 128,188 were LTRAs users. The use of LTRAs significantly reduced cancer risk (HR: 0.60; 95 % CI: 0.40-0.89; p = 0.011), and this was consistent in individuals <65 years (HR: 0.8729; 95 % CI: 0.8479-0.8985; p < 0.001) as well as in those ≥65 years (HR: 0.7510; 95 % CI: 0.7110-0.7933; p < 0.001). Additionally, our data support that the use of LTRAs decreases the risk of urological cancer (HR: 0.91; 95 % CI: 0.8593-0.98;p = 0.014). Moreover, our study showed that the use of LTRAs does not appear to influence the risk of lung cancer (HR: 0.64; p = 0.086), brain cancer (HR: 0.78; p = 0.343), breast cancer (HR: 0.28; p = 0.239), colorectal cancer (HR: 0.56; p = 0.183), gastric cancer (HR: 0.57; p = 0.108), liver cancer (HR: 0.54; p = 0.099), pancreatic cancer (HR: 0.64; p = 0.432), or skin cancer (HR: 1; p = 0.95).This is the first meta-analysis to mention the potential chemopreventive action of LTRAs and their impact on cancer risk among patients with asthma. Our findings support that LTRAs are safe and that their prolonged use in asthma may reduce the overall risk of cancer, especially urological cancers.