title: Prognostic Value for Incidental Antihypertensive Therapy With β-Blockers in Metastatic Colorectal Cancer.
abstract: Previous studies suggested that the incidental use of β-blockers might influence clinical outcome in solid tumors. We assessed the correlation between the incidental use of β-blockers and clinical outcome in colorectal cancer patients treated with first-line chemotherapy alone or in combination with bevacizumab in metastatic colorectal cancer patients. We collected data from 235 metastatic colorectal cancer patients treated with first-line chemotherapy alone (128 patients) or with bevacizumab (107 patients). Patients were stratified for clinical factors such as β-blockers use, age, sex, and site of metastases, previous adjuvant chemotherapy and ECOG performance status. In the chemotherapy alone group patients receiving β-blockers showed an improved overall survival (median OS 41.3 vs 25.7 months, P = 0.03, HR: 2.26, 95% CI: 1.05-3.24). A significant relationship with improved response rate was also evident for B-blocker users (P = 0.044). On the contrary in the β-blockers users group treated with chemotherapy in combination with bevacizumab we observed a trend toward a worse overall survival although nonstatistically significant (median OS 18.5 vs 23.6 months, HR: 0. 89, 95% CI: 0.38-2.03, P = 0.77). Our analysis confirmed a potential prognostic role for the use of β-blockers in colorectal cancer patients treated with chemotherapy. Our findings also suggest a potential worse outcome for patients on β-blockers receiving bevacizumab. Future prospective studies should include the incidental use of β-blockers as stratification factor for clinical outcome.
authors.affiliation: From the Department of Medical Oncology, Translational Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", , Ancona, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Giampieri
authors.forename: Mario
authors.initials: M
authors.lastname: Scartozzi
authors.forename: Michela
authors.initials: M
authors.lastname: Del Prete
authors.forename: Luca
authors.initials: L
authors.lastname: Faloppi
authors.forename: Maristella
authors.initials: M
authors.lastname: Bianconi
authors.forename: Francesca
authors.initials: F
authors.lastname: Ridolfi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents; D000068258:Bevacizumab