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

Jack 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

doi:10.1002/cncr.29392

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

Journal article

Open access

Peer reviewed

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

Jack 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, …

Cancer, Vol.121(19), pp.3444-3451

10/01/2015

DOI: 10.1002/cncr.29392

PMCID: PMC4575637

PMID: 26301456

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Abstract

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]). 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. 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). 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.

Prognosis

Humans

Middle Aged

Ovarian Neoplasms - mortality

Young Adult

Disease-Free Survival

Survival Analysis

Aged, 80 and over

Adult

Female

Aged

Retrospective Studies

Ovarian Neoplasms - drug therapy

Adrenergic beta-Antagonists - therapeutic use

Details

Title: Subtitle: Clinical impact of selective and nonselective beta-blockers on survival in patients with ovarian cancer
Creators: Jack L Watkins - Department of Clinical Effectiveness, The University of Texas MD Anderson Cancer Center, Houston, Texas
Premal H Thaker - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
Alpa M Nick - Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Lois M Ramondetta - Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Sanjeev Kumar - Division of Obstetrics and Gynecology, The Mayo Clinic, Rochester, Minnesota
Diana L Urbauer - Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
Koji Matsuo - Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Mercy Medical Center, Baltimore, Maryland
Kathryn C Squires - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
Robert L Coleman - Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Susan K Lutgendorf - Department of Urology, University of Iowa, Iowa City, Iowa
Pedro T Ramirez - Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Anil K Sood - Center for RNA Interference and Non-Coding RNA Program, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
Resource Type: Journal article
Publication Details: Cancer, Vol.121(19), pp.3444-3451
DOI: 10.1002/cncr.29392
PMID: 26301456
PMCID: PMC4575637
NLM abbreviation: Cancer
ISSN: 0008-543X
eISSN: 1097-0142
Publisher: United States
Grant note: CA104825 / NCI NIH HHS R01 CA104825 / NCI NIH HHS P50CA083639 / NCI NIH HHS CA016672 / NCI NIH HHS R01 CA109298 / NCI NIH HHS U54 CA096300 / NCI NIH HHS CA109298 / NCI NIH HHS R01 CA140933 / NCI NIH HHS CA140933 / NCI NIH HHS P30 CA016672 / NCI NIH HHS U54CA151668 / NCI NIH HHS U54 CA151668 / NCI NIH HHS P50 CA083639 / NCI NIH HHS U54 CA096297 / NCI NIH HHS U54CA96297 / NCI NIH HHS U54CA96300 / NCI NIH HHS
Language: English
Date published: 10/01/2015
Academic Unit: Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
Record Identifier: 9984002487802771

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