Preclinical studies have demonstrated that adrenergic agonists mediate tumor growth and invasiveness in ovarian cancer models via the beta-2 adrenergic receptor. Studies have also investigated the clinical impact of beta blocker use on epithelial ovarian cancer (EOC) survival with conflicting results. We aim to understand the association between peri-operative beta blockade and clinical outcomes in EOC patients.
We conducted an institutional retrospective chart review and examined the effects of beta blocker use on overall survival (OS) and progression free survival (PFS) when looking at peri-operative timing of beta blocker use in EOC.
In a cox survival model, women who took a selective beta blocker (SBB) in the peri-operative period were four times more likely to die compared to nonusers when looking at OS (adjusted SBB HR 5.82, 95% CI 1.17-28.91, p=0.031). Although there was no difference in PFS between nonselective beta blocker (NSBB) users and nonusers (adjusted NSBB HR 1.88, 95% CI 0.41-8.60, p=0.414), SBB users were four times more likely to have recurrence of disease compared to nonusers (adjusted SBB HR 4.24, 95% CI 1.23-14.55, p=0.022).
Compared to never use, SBB use peri-operatively was associated with poorer OS and ever SBB use was associated with poorer PFS in patients with EOC. This is an area that warrants further investigation as preclinical studies would suggest a potential survival benefit, but reports in the literature are conflicting and our data seem to suggest a potential harm with SBB use.