TY - JOUR
T1 - Beta-Blocker Use Is Associated With Worse Relapse-Free Survival in Patients With Head and Neck Cancer
AU - Chen, Hannah Y
AU - Zhao, Weilu
AU - Na'ara, Shorook
AU - Gleber-Netto, Frederico O
AU - Xie, Tongxin
AU - Ali, Shahrukh
AU - Thompson, Zachary M
AU - Buell, Jane
AU - Stafford, Haleigh
AU - Nagarajan, Priyadharsini
AU - Davies, Michael
AU - Wong, Michael K
AU - Migden, Michael R
AU - Sharma, Padmanee
AU - Myers, Jeffrey N
AU - Gross, Neil D
AU - Amit, Moran
PY - 2023/6
Y1 - 2023/6
N2 - PURPOSE: Although beta-blockers (BBs) have been hypothesized to exert a beneficial effect on cancer survival through inhibition of beta-adrenergic signaling pathways, clinical data on this issue have been inconsistent. We investigated the impact of BBs on survival outcomes and efficacy of immunotherapy in patients with head and neck squamous cell carcinoma (HNSCC), non-small-cell lung cancer (NSCLC), melanoma, or squamous cell carcinoma of the skin (skin SCC), independent of comorbidity status or cancer treatment regimen.METHODS: Patients (N = 4,192) younger than 65 years with HNSCC, NSCLC, melanoma, or skin SCC treated at MD Anderson Cancer Center from 2010 to 2021 were included. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were calculated. Kaplan-Meier and multivariate analyses adjusting for age, sex, TNM staging, comorbidities, and treatment modalities were performed to assess the effect of BBs on survival outcomes.RESULTS: In patients with HNSCC (n = 682), BB use was associated with worse OS and DFS (OS: adjusted hazard ratio [aHR], 1.67; 95% CI, 1.06 to 2.62;
P = .027; DFS: aHR, 1.67; 95% CI, 1.06 to 2.63;
P = .027), with DSS trending to significance (DSS: aHR, 1.52; 95% CI, 0.96 to 2.41;
P = .072). Negative effects of BBs were not observed in the patients with NSCLC (n = 2,037), melanoma (n = 1,331), or skin SCC (n = 123). Furthermore, decreased response to cancer treatment was observed in patients with HNSCC with BB use (aHR, 2.47; 95% CI, 1.14 to 5.38;
P = .022).
CONCLUSION: The effect of BBs on cancer survival outcomes is heterogeneous and varies according to cancer type and immunotherapy status. In this study, BB intake was associated with worse DSS and DFS in patients with head and neck cancer not treated with immunotherapy, but not in patients with NSCLC or skin cancer.
AB - PURPOSE: Although beta-blockers (BBs) have been hypothesized to exert a beneficial effect on cancer survival through inhibition of beta-adrenergic signaling pathways, clinical data on this issue have been inconsistent. We investigated the impact of BBs on survival outcomes and efficacy of immunotherapy in patients with head and neck squamous cell carcinoma (HNSCC), non-small-cell lung cancer (NSCLC), melanoma, or squamous cell carcinoma of the skin (skin SCC), independent of comorbidity status or cancer treatment regimen.METHODS: Patients (N = 4,192) younger than 65 years with HNSCC, NSCLC, melanoma, or skin SCC treated at MD Anderson Cancer Center from 2010 to 2021 were included. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were calculated. Kaplan-Meier and multivariate analyses adjusting for age, sex, TNM staging, comorbidities, and treatment modalities were performed to assess the effect of BBs on survival outcomes.RESULTS: In patients with HNSCC (n = 682), BB use was associated with worse OS and DFS (OS: adjusted hazard ratio [aHR], 1.67; 95% CI, 1.06 to 2.62;
P = .027; DFS: aHR, 1.67; 95% CI, 1.06 to 2.63;
P = .027), with DSS trending to significance (DSS: aHR, 1.52; 95% CI, 0.96 to 2.41;
P = .072). Negative effects of BBs were not observed in the patients with NSCLC (n = 2,037), melanoma (n = 1,331), or skin SCC (n = 123). Furthermore, decreased response to cancer treatment was observed in patients with HNSCC with BB use (aHR, 2.47; 95% CI, 1.14 to 5.38;
P = .022).
CONCLUSION: The effect of BBs on cancer survival outcomes is heterogeneous and varies according to cancer type and immunotherapy status. In this study, BB intake was associated with worse DSS and DFS in patients with head and neck cancer not treated with immunotherapy, but not in patients with NSCLC or skin cancer.
KW - Humans
KW - Squamous Cell Carcinoma of Head and Neck
KW - Carcinoma, Non-Small-Cell Lung/pathology
KW - Prognosis
KW - Lung Neoplasms/pathology
KW - Neoplasm Recurrence, Local
KW - Head and Neck Neoplasms/drug therapy
KW - Melanoma
U2 - 10.1200/PO.22.00490
DO - 10.1200/PO.22.00490
M3 - Article
C2 - 37285560
SN - 2473-4284
VL - 7
SP - e2200490
JO - JCO Precision Oncology
JF - JCO Precision Oncology
ER -