Clinical impact of selective and nonselective beta‐blockers on survival in patients with ovarian cancer

JL Watkins, PH Thaker, AM Nick, LM Ramondetta… - Cancer, 2015 - Wiley Online Library
JL Watkins, PH Thaker, AM Nick, LM Ramondetta, S Kumar, DL Urbauer, K Matsuo…
Cancer, 2015Wiley Online Library
BACKGROUND Preclinical evidence has suggested that sustained adrenergic activation
can promote ovarian cancer growth and metastasis. The authors examined the impact of
beta‐adrenergic blockade on the clinical outcome of women with epithelial ovarian, primary
peritoneal, or fallopian tube cancers (collectively, epithelial ovarian cancer [EOC]).
METHODS A multicenter review of 1425 women with histopathologically confirmed EOC
was performed. Comparisons were made between patients with documented beta‐blocker …
BACKGROUND
Preclinical evidence has suggested that sustained adrenergic activation can promote ovarian cancer growth and metastasis. The authors examined the impact of beta‐adrenergic blockade on the clinical outcome of women with epithelial ovarian, primary peritoneal, or fallopian tube cancers (collectively, epithelial ovarian cancer [EOC]).
METHODS
A multicenter review of 1425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta‐blocker use during chemotherapy and those without beta‐blocker use.
RESULTS
The median age of patients in the current study was 63 years (range, 21‐93 years). The sample included 269 patients who received beta‐blockers. Of those, 193 (71.7%) were receiving beta‐1–adrenergic receptor selective agents, and the remaining patients were receiving nonselective beta antagonists. The primary indication for beta‐blocker use was hypertension but also included arrhythmia and postmyocardial infarction management. For patients receiving any beta‐blocker, the median overall survival (OS) was 47.8 months versus 42 months for nonusers (P =.04). The median OS based on beta‐blocker receptor selectivity was 94.9 months for those receiving nonselective beta‐blockers versus 38 months for those receiving beta‐1–adrenergic receptor selective agents (P<.001). Hypertension was associated with decreased OS compared with no hypertension across all groups. However, even among patients with hypertension, a longer median OS was observed among users of a nonselective beta‐blocker compared with nonusers (38.2 months vs 90 months; P<.001).
CONCLUSIONS
Use of nonselective beta‐blockers in patients with EOC was associated with longer OS. These findings may have implications for new therapeutic approaches. Cancer 2015;121:3435–43. © 2015 American Cancer Society.
Wiley Online Library