title: Therapeutic effect of β-blockers in triple-negative breast cancer postmenopausal women.
abstract: Beta-blockers (BB) drugs have been used for decades worldwide, mainly to treat hypertension. However, in recent epidemiological studies, BBs were suggested to improve cancer prognosis. In the wake of this evidence, we evaluated the possible therapeutic effect of BBs in triple-negative breast cancer (TNBC) patients. We identified 800 postmenopausal women operated between 1997 and 2008 for early primary TNBC. The effect of BB intake on the risk of breast cancer (BC) recurrence and death was evaluated through competing risk and Cox regression survival models. At cancer diagnosis, 74 (9.3 %) women out of 800 were BBs users. Median age was 62 years in BB users and 59 years in non-users (P = 0.02). BB users and non-users were similarly distributed by all tumor characteristics. The 5-year cumulative incidence of BC-related events was 13.6 % in BB users and 27.9 % in non-users (P = 0.02). The beneficial impact of BBs remained statistically significant at multivariable analysis (HR, 0.52; 95 % CI 0.28-0.97), after the adjustment for age, tumor stage, and treatment, peritumoral vascular invasion and use of other antihypertensive drugs, antithrombotics, and statins. Adjusted HRs for metastases and for BC deaths were 0.32 (95 % CI 0.12-0.90) and 0.42 (95 % CI 0.18-0.97), respectively, in favor of BBs. Hypertension, other antihypertensive drugs, antithrombotics, and statins did not impact prognosis. In this series of postmenopausal TNBC patients, BB intake was associated with a significantly decreased risk of BC-related recurrence, metastasis, and BC death. Innovative therapeutic strategies including BBs should be urgently explored in cancer patients.
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. edoardo.botteri@ieo.it
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Munzone
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Carlo
authors.initials: C
authors.lastname: Cipolla
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.forename: Barbara
authors.initials: B
authors.lastname: Santillo
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Zanelotti
authors.forename: Laura
authors.initials: L
authors.lastname: Adamoli
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000453:epidemiology; D017698:Postmenopause; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents