Beta-Blockers Found to Improve Ovarian Cancer Survival
A study recently published in Cancer found that women with newly diagnosed epithelial ovarian cancer (EOC) taking beta-blockers had a more than 5-month increase in median overall survival compared with women not taking the drugs. Unlike previous studies that investigated the impact of beta-blocker use in cancer progression, with mixed results, the current study differentiated between two types of beta-blockers.
The multicenter, retrospective study, led by Jack L. Watkins, PharmD (The University of Texas MD Anderson Cancer Center, Houston), included 1425 women with ovarian cancer who were diagnosed and treated with at least one cycle of platinum-based doublet chemotherapy from 2000 to 2010 at four institutions. Patient charts were reviewed for the presence of hypertension or diabetes mellitus, tumor characteristics, cancer treatments, surgical outcome, use of beta-blockers, and survival data. Use of beta-blockers was defined as any documentation of a beta-blocker in the medical record during neoadjuvant or adjuvant chemotherapy. The median age of the study cohort was 63 years (range, 21-93 years). Of the 269 patients using beta-blockers, 71.7% were taking beta-1 adrenergic receptor selective agents, and the remaining used an older generation beta-blocker called nonselective beta antagonists. The primary indicator for beta-blocker use was hypertension but also included arrhythmia and post-myocardial infarction management.
The researchers noted that beta-blocker users presented at a more advanced stage of disease, had an increased average body mass index, and were more likely to be hypertensive—factors associated with decreased survival. Yet the median overall survival was longer for patients receiving any beta-blockers compared with non-users (47.8 months vs 42 months, respectively; P=.04). Although no difference in median overall survival was observed between patients taking beta-1-adrenergic receptor selective agents and non-users, patients taking nonselective beta-blockers had a longer median overall survival than non-users (94.9 vs 42 months, respectively; P<.001).
Additionally, hypertension was associated with decreased overall survival in all patients groups. Among patients with hypertension, any beta-blocker use resulted in longer median overall survival compared with non-users (49 months vs 34.2 months, respectively, P<.001). Patients taking nonselective beta-blockers had longer median overall survival (90.0 months) than with patients taking beta-1-adrenergic receptor selective agents (38.2 months; P<.001).
“The ability to improve survival of patients with EOC via ADRB2 blockade using beta-blockers would be the culmination of years of research into the biology and pathogenesis of EOC,” the researchers wrote.—Eileen Koutnik-Fotopoulos
Watkins JL, Thaker PH, Nick AM, et al. Clinical impact of selective and nonselective beta-blockers on survival in patients with ovarian cancer [published online ahead of print August 24, 2015]. Cancer. doi:10.1002/cncr.29392.