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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
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