Abstract
To determine whether beta-blockers (BBs) improve the overall survival (OS) of patients with metastatic non-small cell lung cancer (NSCLC). The medical charts of 107 patients with metastatic NSCLC were retrospectively assessed. Thirty-five patients (BB group) using BBs during chemotherapy (CT) were compared with 72 controls [control=(C) group] who did not use BBs following the diagnosis of NSCLC. The histological tumor subtype, performance status (ECOG), age, gender, smoking status, comorbidities, other medications and chemotherapeutics that were received in any line of treatment were recorded. We compared the overall survival (OS) of the patients in the BB and C groups. The mean age of the patients was 61 years (range 42-81 years) and all patients were administered CT. The BB group was more likely to have HT and IHD and was more likely to use RAS blockers (p<0.01 for all) compared with the C group, as expected. The mean follow-up time was 17.8 months (range 1-102 months) for the entire group. The most commonly prescribed BB agent was metoprolol (80% of cases). At the time of the analysis, 74 (69%) of all patients had died. In the univariate analysis the median overall survival (OS) was 19.25 (±2.87) months (95%CI: 13.62-24.88) in the BB group and 13.20 (±2.37) months (95%CI: 8.55-17.85) in the C group (p=0.017). However, the benefit of BBs on survival disappeared in the multivariate analysis. The use of BBs during CT may be associated with an improved OS for patients with metastatic NSCLC.
Highlights
Non-small cell lung cancer (NSCLC) is a common cause of cancer death worldwide, despite all of the current cancer therapeutics (Jemal et al, 2007)
In the univariate analysis the median overall survival (OS) was 19.25 (±2.87) months (95%confidence intervals (CIs): 13.62-24.88) in the BB group and 13.20 (±2.37) months (95%CI: 8.55-17.85) in the C group (p=0.017)
We evaluated whether the use of BBs had an effect on survival by comparing these 35 patients with 72 age, sex- and histological subtype-matched counterparts who did not use BBs at any time after the diagnosis of non-small cell lung cancer (NSCLC) [control (C) group]
Summary
Non-small cell lung cancer (NSCLC) is a common cause of cancer death worldwide, despite all of the current cancer therapeutics (Jemal et al, 2007). Beta-adrenergic signaling stimulates cancer growth (Al-Wadei et al, 2012; Cole and Sood, 2012). Preclinical studies have demonstrated that beta-adrenergic receptor (AR) signaling has strong stimulating effects in cancers of the colon (Masur et al, 2001; Wong et al, 2007), prostate (Palm et al, 2006), ovary (Sood et al, 2006; Thaker et al, 2006), breast (Drell et al, 2003) and pancreas (Al-Wadei et al, 2009). Regarding the impact of beta-blockers (BBs) on cancer survival, a recent study showed that BBs reduce the development of metastasis and recurrence in non-metastatic breast cancer and improve cancer-specific survival (Powe et al, 2010). Preclinical studies have shown that beta-adrenergic signaling could stimulate NSCLC growth (Schuller et al, 1999; Laag et al, 2006)
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