Beta-Blockers Linked to Increased Survival Rates in Patients with Ovarian Cancer

Beta-blockers found reduce to stress from hormones that fuel disease progression.

A generic heart medication was shown to improve the survival of patients with ovarian cancer in a recent study.

The medications, known as beta-blockers, demonstrated a benefit in overall survival among patients with epithelial ovarian cancer (EOC). According to researchers at the University of Texas MD Anderson Cancer Center, the beta-blockers inhibit the effects of stress pathways involved in tumor metastasis.

The study evaluated 1425 women with ovarian cancer treated between 2000 and 2010. Researchers compared overall survival among patients with documented beta-blocker use during chemotherapy and those without.

Of the 269 patients who received beta-blockers, approximately 72% received beta-1-adrenergic receptor selective agents (SBBs) and the remaining patients received nonselective beta antagonists (NSBBs).

The research found that for patients receiving any beta-blocker, the median overall survival was 47.8 months versus 42 months for nonusers. Additionally, median overall survival based on beta-blocker receptor selectivity was 94.9 months for those receiving NSBBs versus 38 months for those receiving SBBs.

This trend continued even among patients with hypertension, as NSBB users with an overall survival rate of 90 months compared favorably to nonusers who had an overall survival rate of 38.2 months.

The research builds on what has already been determined through prior research by principal investigator Anil Sood, MD. He found that stress hormones fuel progression of ovarian and other cancers, and that beta-blockers work to reduce that stress.

“Beta-blockers treat a variety of conditions, such as heart disease, high-blood pressure, glaucoma and migraines. They target a receptor protein in heart muscle that causes the heart to beat harder and faster when activated by stress hormones,” Dr. Sood said. “Our research has shown that the same stress mechanisms impact ovarian cancer progression, so these drugs could play a new role in cancer treatment. The ability to show improved survival using nonselective agents — which inhibit a specific stress pathway – is the culmination of years of research into ovarian cancer biology and pathogenesis.”

Dr. Sood also added that beta-blocker users in the study who presented at a higher stage of disease had an increased average BMI and were more likely to be hypertensive. These factors were associated with decreased survival, but those who received beta-blockers experienced equivalent or improved survival rates.

Additionally, NSBB users were found to have increased survival regardless of the presence of comorbidities. The same was not true of SBB-users.

While further study may be needed, the results of the study highlight the importance of adrenergic receptor-β2 (ADRB2), a signaling pathway important to ovarian carcinogenesis and targeted by NSBBs (versus the ADRB1 pathway targeted by SBBs). Future trials aim to identify patients who would benefit most from beta-blocker use and the best beta-blocker for a specific tumor type based on adrenergic receptor expression. Only then can scientists hope to use beta-blockers as an adjuvant therapy during surgical recovery and chemotherapy to decrease tumor growth, delays in wound healing, and metastasis.

“The stratification of patients by beta-blocker use and selectivity in this study makes it unique among all other studies examining the impact of these drugs on cancer,” Dr. Sood said. “It also builds on the mounting evidence that beta-blockers may become a key treatment component for many patients in the future.”