Losartan as a mechanotherapeutic adjuvant: Remodeling the breast tumor microenvironment to improve treatment efficacy

PLoS One. 2025 Jul 11;20(7):e0328196. doi: 10.1371/journal.pone.0328196. eCollection 2025.

Abstract

Tumor stiffness is a critical factor influencing cancer progression, therapeutic resistance, and drug delivery. This study investigates the role of mechanical normalization in breast cancer therapy through the anti-fibrotic action of losartan, an angiotensin II type 1 receptor blocker. We developed a comprehensive multiphysics model integrating tumor cell proliferation, oxygen transport, interstitial fluid dynamics, and losartan pharmacokinetics/pharmacodynamics (PK/PD). Simulations demonstrate that losartan reduces tumor stiffness by up to 28%, enhances oxygenation by 8%, and increases tumor porosity by ~45%, thereby enhancing drug penetration and interstitial transport. Furthermore, tumor cell concentration decreased by 88%, reflecting the drug's dual anti-proliferative and pro-apoptotic effects. Spatial analyses revealed heterogeneity in stiffness reduction and drug response, emphasizing the importance of tumor geometry and perfusion. Our findings support the potential of losartan as a mechanotherapeutic adjuvant to enhance standard cancer treatments by remodeling the tumor microenvironment and overcoming mechanical barriers to therapy.

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers* / pharmacokinetics
  • Angiotensin II Type 1 Receptor Blockers* / pharmacology
  • Angiotensin II Type 1 Receptor Blockers* / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / metabolism
  • Breast Neoplasms* / pathology
  • Cell Proliferation / drug effects
  • Female
  • Humans
  • Losartan* / pharmacokinetics
  • Losartan* / pharmacology
  • Losartan* / therapeutic use
  • Models, Biological
  • Treatment Outcome
  • Tumor Microenvironment* / drug effects

Substances

  • Losartan
  • Angiotensin II Type 1 Receptor Blockers