Multivariable analysis of association of beta-blocker use and survival in advanced ovarian cancer

Gonzalez, Rafael; Gockley, Allison; Melamed, Alexander; Clark, R.M.; Schorge, John O.; Carmen, M.G. del; Berkowitz, Ross S.; Horowitz, Noya; Muto, Michael G.; Worley, M.J.

doi:10.1016/j.ygyno.2018.04.477

Cited by 2 publications

(4 citation statements)

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“…We found that perioperative SBB use did not affect survival outcomes, a finding also reported by several others. 18,35 Yet, survival advantage has been reported in some studies. Watkins et al 16 reported SBB survival advantage at 1 year postdiagnosis for women without hypertension, but by 5 years postdiagnosis, this had reversed to survival disadvantage.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…15,16 Another study of patients at high risk of adverse cardiac outcomes reported that patients administered prophylactic perioperative metoprolol, a selective beta-1 AR blocker, had some evidence of improved overall survival but no difference in progression-free survival. 17 Gonzalez et al 18 reported worse overall survival for 105 women taking beta-blockers (BBs) at time of surgery compared with women who did not, but they did not separate findings by selectivity.…”

Section: Data Supplementmentioning

confidence: 99%

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Perioperative Beta-Blocker Supply and Survival in Women With Epithelial Ovarian Cancer and a History of Cardiovascular Conditions

Spilsbury

Tuesley

Pearson

et al. 2023

JCO

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PURPOSE Surgery for epithelial ovarian cancer (EOC) may activate stress-inflammatory responses that stimulate tumor growth and increase metastatic growth. Animal and in vitro studies have shown that inhibition of the catecholamine-induced inflammatory response via beta-adrenergic receptor blockade has antitumor potential in EOC. However, observational studies have reported mixed results. We assessed whether beta-blocker (BB) use at the time of primary ovarian cancer surgery was associated with improved survival in a large population-based study. MATERIALS AND METHODS Using linked administrative data, a population-based cohort of 3,844 Australian women age 50 years or older with a history of cardiovascular conditions who underwent surgery for EOC was followed for survival outcomes. The average treatment effect of selective BB (SBB) and nonselective BB (NSBB) supply at the time of surgery on survival was estimated from a causal inference perspective using covariate-balanced inverse probability of treatment weights with flexible parametric survival models that allowed for time-varying survival effects. RESULTS Around the time of surgery, 560 (14.5%) women were supplied a SBB and 67 (1.7%) were supplied a NSBB. At 2 years postsurgery, the survival proportion was 80% (95% CI, 68 to 88) for women dispensed NSBBs at surgery compared with 69% (95% CI, 67 to 70) for women not supplied NSBBs. The survival advantage appeared to extend to at least 8 years postsurgery. No association was observed for women dispensed a SBB around the time of surgery. CONCLUSION Perioperative supply of NSBBs appeared to confer a survival advantage for women age over 50 years with a history of cardiovascular conditions. Long-term clinical trials are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Data Supplementmentioning

confidence: 99%

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Perioperative Beta-Blocker Supply and Survival in Women With Epithelial Ovarian Cancer and a History of Cardiovascular Conditions

Spilsbury

Tuesley

Pearson

et al. 2023

JCO

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“…Furthermore, a study showed that perioperative treatment with propranolol and a COX-2 inhibitor caused a decrease in biomarkers related to breast cancer recurrence and metastasis [ 66 ]. Similarly, studies in patients with ovarian cancer have shown a positive effect [ 67 ], no significant effect [ 68 , 69 ], or even negative effects [ 70 , 71 ]. In the same manner, evidence has shown that β-blockers may have a role in the treatment of melanoma [ 72 ] yet the data are inconclusive and the efficacy not always apparent [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Does sympathetic nervous system modulate tumor progression? A narrative review of the literature

Stavropoulos

Sarantopoulos

Liverezas

2020

Journal of Drug Assessment

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Objective: The role of the sympathetic nervous system (SNS) in tumor development, progression and metastasis is studied for more than half a century and is attracting more attention during the last years. In this narrative review, we aim to a chronological and methodological presentation of the most interesting and pioneering studies on the subject. Methods: The complexity of the autonomic nervous system's interaction with the immune system, its direct and indirect effects on tumors and their surrounding tissues, plus the diversity and heterogeneity in the design and methodology of the studies, provide hard-to-interpret data and, at times, controversial findings. Studies are categorized into four main groups regarding the distribution of sympathetic nerve fibers inside the tumor, the effect of sympathectomy on cancer progression, the role of neurotransmitters on tumor growth and the impact of sympathetic adrenergic signaling on the anti-tumor immune response. Results: Studies from all four categories converge to a common point. There is strong evidence that SNS function plays a role in the development and progression of tumors and subsequently the modification of SNS function, locally or diffusely, can affect the course of tumor growth. Conclusion: The impact of SNS function on cancer behavior may be exerted in two ways, directly via the sympathetic nerve fibers or through widely distributed neurotransmitters. Modification of them, combined or not with treatments altering the immune function, could be the target for future therapeutic implications.

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Multivariable analysis of association of beta-blocker use and survival in advanced ovarian cancer

Cited by 2 publications

References 0 publications

Perioperative Beta-Blocker Supply and Survival in Women With Epithelial Ovarian Cancer and a History of Cardiovascular Conditions

Perioperative Beta-Blocker Supply and Survival in Women With Epithelial Ovarian Cancer and a History of Cardiovascular Conditions

Does sympathetic nervous system modulate tumor progression? A narrative review of the literature

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