Beta-Blockers Linked With Extended Ovarian Cancer Survival

Beta-blockers were associated with increased overall survival in women with epithelial ovarian cancer, according to the results of a recently published retrospective study.

In the analysis, women who received any beta-blocker had a more than 5-month increase in median overall survival compared with women not receiving beta-blockers.

“The ability to improve the survival of patients with epithelial ovarian cancer via ADRB2 blockade using beta-blockers would be the culmination of years of research into the biology and pathogenesis of epithelial ovarian cancer,” Jack L. Watkins, PharmD, of the University of Texas MD Anderson Cancer Center, and colleagues wrote in Cancer.

“Particularly interesting is the finding that beta-blocker users in the current study presented at a higher stage of disease, had an increased average BMI, and were more likely to be hypertensive,” they wrote. “All these factors were associated with decreased survival, yet those who received beta-blockers had either equivalent or improved overall survival.”

In the study, the researchers reviewed 1,425 women with epithelial ovarian cancer and compared outcomes among those who had used beta-blockers during chemotherapy (n = 269) and those without beta-blocker use.

Of the women using beta-blockers, 71.7% were taking beta-1-adrengenic receptor selective agents with the rest taking nonselective beta antagonists.

The median overall survival for women taking any beta-blocker was 47.8 months compared with 42 months for non-users (P = .04). The researchers observed no significant difference in overall survival based on beta-blocker selectivity.

The median overall survival for women taking nonselective beta-blockers was 94.9 months compared with 38 months for women receiving beta-1-adrenergic receptor selective agents (P < .001).

“Because optimal cytoreduction is a known prognostic factor for survival and differed between the patients treated with selective beta-blockers (69.9%) and those treated with non-selective beta-blockers (79.7%), this finding was analyzed and the importance of taking any type of beta-blocker with the use of optimal or suboptimal cytoreduction remained in the first year except for patients with selective beta-blockers and hypertension,” the researchers wrote.

Watkins and colleagues also found that hypertension was associated with a decreased overall survival in all patient groups. Any beta-blocker use resulted in a longer median overall survival compared with non-use (49 months vs 34.2 months; P < .001). In addition, patients taking selective beta-blockers had a longer median overall survival than non-users (38.2 months vs 34.2 months; P = .007). Finally, patients taking non-selective beta-blockers were found to have a median overall survival of 90 months, significantly longer than that observed for patients taking either selective beta-blockers or non-users of beta-blockers with elevated blood pressure (P < .001).

In an editorial that accompanied the study, Kristen P. Bunch, MD, and Christina M. Annunziata, MD, PhD, of the Women’s Malignancies Branch of the National Cancer Institute, wrote that the results of this study were intriguing and warrant further research into beta-blockers as an anticancer strategy.

However, they also pointed out that the use of beta-blockers are part of a treatment regimen for women with ovarian cancer does have some risks, including the potential side effects of the drugs such as bronchospasm, fatigue, hypotension, and hyperglycemia.

“Prospective studies and randomized clinical trials must address optimal dosing regimens, timing of treatment, and the impact of different classes of beta-blockers on survival among patients with epithelial ovarian cancer to guide treatment options,” Bunch and Annunziata wrote. “Such medications may have particular relevance in this patient population, among whom hypertension is prevalent. This study lays the groundwork for insightful investigation into repurposing cardiovascular medications to cancer therapeutics.”