Abstract
Beta-blocker (BB) is suggested to have anticancer efficacy. However, the potential influence of BB use on overall survival (OS) in patients with lung cancer remains undetermined. We aimed to evaluate the above relationship in an updated meta-analysis. Observational studies comparing OS between users and non-users of BB with lung cancer were identified by search of PubMed, Embase, and Cochrane's Library. A random-effect model was used to pool the results. Ten retrospective cohort studies with 30870 patients were included. Overall, BB use was not associated with significantly improved OS in lung cancer (hazard ratio [HR] = 1.02, 95% confidence interval [CI]: 0.98 to 1.06, p = 0.33) with moderate heterogeneity (I2 = 29%). Stratified analyses showed similar results in patients with non-small cell lung cancer and small cell lung cancer, in studies with BB use before and after the diagnosis of lung cancer, and in studies with or without adjustment of smoking. Use of BB was associated with improved OS in patients with stage III lung cancer (HR = 0.91, 95% CI: 0.85 to 0.98, p = 0.02) and in patients that did not receive surgery resection (HR = 0.78, 95% CI: 0.64 to 0.96, p = 0.02), while use of non-selective BB was associated with worse OS (HR = 1.14, 95% CI: 1.01 to 1.28, p = 0.03). This meta-analysis of retrospective cohort studies does not support a significant association between BB use and improved OS in lung cancer.
Highlights
Lung cancer is one of the most common cancers worldwide [1, 2]
BB use was not associated with significantly improved overall survival (OS) in lung cancer with moderate heterogeneity (I2 = 29%)
Use of BB was associated with improved OS in patients with stage III lung cancer (HR = 0.91, 95% confidence intervals (CIs): 0.85 to 0.98, p = 0.02) and in patients that did not receive surgery resection (HR = 0.78, 95% CI: 0.64 to 0.96, p = 0.02), while use of non-selective BB was associated with worse OS (HR = 1.14, 95% CI: 1.01 to 1.28, p = 0.03)
Summary
Lung cancer is one of the most common cancers worldwide [1, 2]. lung cancer is the leading cause of cancer-specific mortality for the global population, which results in more than 1.7 million deaths annually [1, 2]. Studies evaluating the association between BB use and survival of lung cancer showed inconsistent results [14,15,16,17,18,19,20,21,22,23]. The potential influences of study characteristics on this association, such as category and stage of lung cancer, timing of BB use, category of BB, and smoking status of the patients, were rarely investigated. This updated meta-analysis was performed to provide a systematic evaluation of the association between BB use and survival of lung cancer and explore the potential influences of above study characteristics on the outcome. We aimed to evaluate the above relationship in an updated meta-analysis
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