title: Treatment with β-blockers and reduced disease progression in patients with thick melanoma.
abstract: Preclinical evidence shows that β-adrenoceptor antagonists (β-blockers) inhibit tumor and metastasis progression in animal models of melanoma. We hypothesized that the use of β-blockers for concomitant diseases is associated with a reduced risk of progression of thick (Breslow thickness >1 mm) malignant melanoma. Two patient subgroups were identified from the medical records of 121 consecutive patients with a thick melanoma. Of these, 30 patients had been prescribed β-blockers for 1 year or more (treated subgroup), whereas the other 91 were untreated. After a median follow-up time of 2.5 years, tumor progression was observed in 3.3% of the treated subgroup and in 34.1% of the untreated subgroup. The Cox model on progression indicated a 36% (95% confidence interval, 11%-54%) (P = .002) risk reduction for each year of β-blocker use. No deaths were observed in the treated group, whereas in the untreated group 24 patients died. To our knowledge, the present study suggests for the first time that exposure to β-blockers for 1 year or more is associated with a reduced risk of progression of thick malignant melanoma, indicating the need for larger epidemiological studies and randomized clinical trials.
authors.affiliation: Department of Dermatology, University of Florence, Florence, Italy. vincenzo.degiorgi@unifi.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.forename: Marta
authors.initials: M
authors.lastname: Grazzini
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
authors.forename: Silvia
authors.initials: S
authors.lastname: Benemei
authors.forename: Torello
authors.initials: T
authors.lastname: Lotti
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Geppetti
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008499:Medical Records; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control*; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000970:Antineoplastic Agents