A new study published May 31 in the Journal of Clinical Oncology reports that beta-blocker use is associated with improved relapse-free survival in all patients with breast cancer, including those with triple-negative breast cancer (TNBC), a particularly aggressive form of the disease.
Previous epidemiological research has shown that breast cancer is potentially more likely to recur in the context of chronic stress and that beta-blockers -- a class of drugs that help in diminishing the effects of the stress pathway by blocking adrenergic stimulation -- may improve breast cancer relapse. These drugs are often used for cardioprotection after heart attacks and to control cardiac arrhythmias and hypertension.
This collaborative study led by Amal Melhem-Bertrandt, M.D., an assistant professor in the Department of Breast Medical Oncology at MD Anderson, found that the use of beta-blockers in patients with breast cancer was associated with an approximately 50% reduction in breast cancer relapse after three years when compared to patients who were not on beta-blockers. The associated improvement in three-year overall survival in the beta-blocker group, although not significant, was approximately 35%.
The retrospective study looked at 1,413 patients from MD Anderson's Breast Cancer Management System Database. All patients had non-metastatic breast cancer and received neoadjuvant chemotherapy between 1995 and 2007. Of these patients:
- 102 were taking beta-blockers at the start of chemotherapy
- 29 had TNBC
The non-beta-blocker group included 348 TNBC patients. The median follow-up time was 55 months among patients in the beta-blocker group and 63 months for patients not using beta-blockers.
Researchers found that for the patients with TNBC, beta-blocker use remained associated with significant improvement in relapse-free survival, and approached significance for overall survival.
"There's a lack of preventive options for women diagnosed with triple-negative breast cancer, so we're encouraged by these findings to further explore how to control the stress pathway in a way that will benefit these patients," Melhem-Bertrandt says. "The findings are certainly compelling, and our next step would be to examine the effects of beta-blockers in a prospective, randomized clinical trial."
Melhem-Bertrandt notes that the current study is limited in scope due to its retrospective nature and sample size, and that further research and clinical trials must be completed to determine the exact benefit of beta-blockers in women with breast cancer, particularly TNBC.
Patients should speak with their doctors before taking beta-blockers, as they can cause blood pressure and heart rate to drop, among other side effects.