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

AbstractBACKGROUND:
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.
AuthorsJack L Watkins, Premal H Thaker, Alpa M Nick, Lois M Ramondetta, Sanjeev Kumar, Diana L Urbauer, Koji Matsuo, Kathryn C Squires, Robert L Coleman, Susan K Lutgendorf, Pedro T Ramirez, Anil K Sood
JournalCancer (Cancer) Vol. 121 Issue 19 Pg. 3444-51 (Oct 01 2015) ISSN: 1097-0142 [Electronic] United States
PMID26301456 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
Copyright© 2015 American Cancer Society.
Chemical References
  • Adrenergic beta-Antagonists
Topics
  • Adrenergic beta-Antagonists (therapeutic use)
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Middle Aged
  • Ovarian Neoplasms (drug therapy, mortality)
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Young Adult

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