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Int J Cancer. 2016 Jul 1;139(1):212-9. doi: 10.1002/ijc.30062. Epub 2016 Mar 12.

Use of beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and breast cancer survival: Systematic review and meta-analysis.

Author information

1
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
2
Division of Medical Senology, European Institute of Oncology, Milan, Italy.
3
Cardiology Division, European Institute of Oncology, Milan, Italy.
4
Division of Medical Oncology, E.O. Ospedali Galliera, Genoa, Italy.
5
Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
6
Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom.

Abstract

Breast cancer (BC) is the second leading cause of cancer death among women in Western Countries. Beta-blocker (BB) drugs, angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) were suggested to have a favorable role in the development and progression of BC. We have performed a meta-analysis to clarify the potential benefits of these drugs on BC survival. A total number of 46 265 BC patients from eleven papers were included, ten independent studies on BB use and seven on ACEi/ARB use. The summary hazard ratio (SHR) was estimated by pooling the study-specific estimates with random effects models and maximum likelihood estimation. We assessed the homogeneity of the effects across studies and evaluated between-study heterogeneity by meta-regression and sensitivity analyses. We found a significant improvement in BC specific survival for patients treated with BB drugs at the time of BC diagnosis (SHR: 0.44; 95%CI: 0.26-0.73 with I(2) = 78%). We also observed a borderline significant improvement in disease free survival for subjects treated with BB (SHR: 0.71, 95%CI: 0.19-1.03). No association of ACEi/ARB use with disease free and overall survival was found. In conclusion, we report epidemiological evidence that BB improve BC-specific survival. Clinical trials addressing this hypothesis are warranted.

KEYWORDS:

angiotensin receptor blockers; angiotensin-converting enzyme inhibitors; antihypertensive drugs; beta-blockers; breast cancer; prognosis

PMID:
26916107
DOI:
10.1002/ijc.30062
[Indexed for MEDLINE]
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