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Cancer. 2015 Oct 1;121(19):3444-51. doi: 10.1002/cncr.29392. Epub 2015 Aug 24.

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

Author information

1
Department of Clinical Effectiveness, The University of Texas MD Anderson Cancer Center, Houston, Texas.
2
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
3
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
4
Division of Obstetrics and Gynecology, The Mayo Clinic, Rochester, Minnesota.
5
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
6
Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Mercy Medical Center, Baltimore, Maryland.
7
Department of Psychology, University of Iowa, Iowa City, Iowa.
8
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa.
9
Department of Urology, University of Iowa, Iowa City, Iowa.
10
Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
11
Center for RNA Interference and Non-Coding RNA Program, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Abstract

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.

KEYWORDS:

beta-blockers; nonselective; ovarian cancer; selective; survival

PMID:
26301456
PMCID:
PMC4575637
DOI:
10.1002/cncr.29392
[Indexed for MEDLINE]
Free PMC Article

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