Abstract
Introduction: Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC).Materials and Methods: Data from clinical trials EMILIA, TH3RESA, MARIANNE, and CLEOPATRA was pooled. Cox proportional analysis was used to assess the association between pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapies.Results: Of the 2,777 patients with HER2 positive ABC, 266 were using a BB at the time of anti-HER2 therapy initiation. BB use was associated with worse overall survival (OS) (adjusted HR = 1.27, 95% CI: 1.04–1.55). Sensitivity analysis in patients with pre-existing cardiovascular disease (CVD) also indicated that BB use was associated with worse OS (1.29, 1.02–1.63).Conclusion: In large high-quality data, BB use at the time of anti-HER2 therapy initiation for ABC was independently associated with worse OS, regardless of CVD status. The finding is contrary to pre-study hypotheses and findings in other BC subtypes. Future research should aim to gain a deeper understanding of the effects of BBs on specific BC subtypes, cancer types, and cancer treatments.
Highlights
Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-Human epidermal growth factor receptor 2 (HER2) therapies
Beta-Blockers in HER2+ Advanced Cancer well-tolerated, they are associated with cardiotoxic effects, which may be further augmented when used in combination with anthracyclines [4, 5]
The effects of BB have not been investigated in patients with HER2 positive advanced breast cancer (ABC) within large high-quality data
Summary
Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC). Pre-clinical evidence indicates that beta-blockers (BB) may have anticancer and immune-boosting effects, and clinical trials investigating the effects of BB on cancer are being initiated [6, 7]. The effects of BB have not been investigated in patients with HER2 positive advanced breast cancer (ABC) within large high-quality data. This is important as research has indicated that BB effects may not be the same between cancer subtypes and treatments [12,13,14]
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