期刊
CANCER
卷 121, 期 19, 页码 3444-3451出版社
WILEY-BLACKWELL
DOI: 10.1002/cncr.29392
关键词
ovarian cancer; beta-blockers; survival; selective; nonselective
类别
资金
- National Institutes of Health [CA140933, CA104825, CA109298, P50CA083639, U54CA151668, U54CA96300, U54CA96297, CA016672]
- Ovarian Cancer Research Fund program Project Development Grant
- Department of Defense [OC073399, W81XWJ-10-0158, OC100237]
- Betty Ann Asche Murray Distinguished Professorship
- RGK Foundation
- Gilder Foundation
- Blanton-Davis Ovarian Cancer Research Program
- Gynecologic Cancer Foundation-St. Louis Ovarian Cancer Awareness grant
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. (C) 2015 American Cancer Society.
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