title: Clinical impact of selective and nonselective beta-blockers on survival in patients with ovarian cancer.
abstract: BACKGROUND
  Preclinical evidence has suggested that sustained adrenergic activation can promote ovarian cancer growth and metastasis. The authors examined the impact of beta-adrenergic blockade on the clinical outcome of women with epithelial ovarian, primary peritoneal, or fallopian tube cancers (collectively, epithelial ovarian cancer [EOC]).
  
  
  METHODS
  A multicenter review of 1425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta-blocker use during chemotherapy and those without beta-blocker use.
  
  
  RESULTS
  The median age of patients in the current study was 63 years (range, 21-93 years). The sample included 269 patients who received beta-blockers. Of those, 193 (71.7%) were receiving beta-1-adrenergic receptor selective agents, and the remaining patients were receiving nonselective beta antagonists. The primary indication for beta-blocker use was hypertension but also included arrhythmia and postmyocardial infarction management. For patients receiving any beta-blocker, the median overall survival (OS) was 47.8 months versus 42 months for nonusers (P =.04). The median OS based on beta-blocker receptor selectivity was 94.9 months for those receiving nonselective beta-blockers versus 38 months for those receiving beta-1-adrenergic receptor selective agents (P<.001). Hypertension was associated with decreased OS compared with no hypertension across all groups. However, even among patients with hypertension, a longer median OS was observed among users of a nonselective beta-blocker compared with nonusers (38.2 months vs 90 months; P<.001).
  
  
  CONCLUSIONS
  Use of nonselective beta-blockers in patients with EOC was associated with longer OS. These findings may have implications for new therapeutic approaches. Cancer 2015;121:3435-43. © 2015 American Cancer Society.
authors: Department of Clinical Effectiveness, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Jack L
authors: JL
authors: Watkins
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
authors: Premal H
authors: PH
authors: Thaker
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Alpa M
authors: AM
authors: Nick
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Lois M
authors: LM
authors: Ramondetta
authors: Division of Obstetrics and Gynecology, The Mayo Clinic, Rochester, Minnesota.
authors: Sanjeev
authors: S
authors: Kumar
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Diana L
authors: DL
authors: Urbauer
authors: Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Mercy Medical Center, Baltimore, Maryland.
authors: Koji
authors: K
authors: Matsuo
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
authors: Kathryn C
authors: KC
authors: Squires
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Robert L
authors: RL
authors: Coleman
authors: Department of Psychology, University of Iowa, Iowa City, Iowa.|Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa.|Department of Urology, University of Iowa, Iowa City, Iowa.
authors: Susan K
authors: SK
authors: Lutgendorf
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Pedro T
authors: PT
authors: Ramirez
authors: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.|Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.|Center for RNA Interference and Non-Coding RNA Program, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors: Anil K
authors: AK
authors: Sood
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: beta-blockers; nonselective; ovarian cancer; selective; survival