Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer

Amal Melhem-Bertrandt, Mariana Chavez-MacGregor, Xiudong Lei, Erika N. Brown, Richard T. Lee, Funda Meric-Bernstam, Anil K. Sood, Suzanne D. Conzen, Gabriel N. Hortobagyi, Ana Maria Gonzalez-Angulo

Research output: Contribution to journalArticle

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Abstract

Purpose: To examine the association between beta-blocker (BB) intake, pathologic complete response (pCR) rates, and survival outcomes in patients with breast cancer treated with neoadjuvant chemotherapy. Patients and Methods: We retrospectively reviewed 1,413 patients with breast cancer who received neoadjuvant chemotherapy between 1995 and 2007. Patients taking BBs at the start of neoadjuvant therapy were compared with patients with no BB intake. Rates of pCR between the groups were compared using a χ2 test. Cox proportional hazards models were fitted to determine the association between BB intake, relapse-free survival (RFS), and overall survival (OS). Results: Patients who used BBs (n = 102) were compared with patients (n = 1,311) who did not. Patients receiving BBs tended to be older and obese (P < .001). The proportion of pCR was not significantly different between the groups (P = .48). After adjustment for age, race, stage, grade, receptor status, lymphovascular invasion, body mass index, diabetes, hypertension, and angiotensin-converting enzyme inhibitor use, BB intake was associated with a significantly better RFS (hazard ratio [HR], 0.52; 95% CI, 0.31 to 0.88) but not OS (P = .09). Among patients with triple-negative breast cancer (TNBC; n = 377), BB intake was associated with improved RFS (HR, 0.30; 95% CI, 0.10 to 0.87; P = .027) but not OS (HR, 0.35; 95% CI, 0.12 to 1.00; P = .05). Conclusion: In this study, BB intake was associated with improved RFS in all patients with breast cancer and in patients with TNBC. Additional studies evaluating the potential benefits of beta-adrenergic blockade on breast cancer recurrence with a focus on TNBC are warranted.

Original languageEnglish (US)
Pages (from-to)2645-2652
Number of pages8
JournalJournal of Clinical Oncology
Volume29
Issue number19
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

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Triple Negative Breast Neoplasms
Recurrence
Survival
Breast Neoplasms
Drug Therapy
Neoadjuvant Therapy
Proportional Hazards Models
Angiotensin-Converting Enzyme Inhibitors
Adrenergic Agents
Body Mass Index
Survival Rate

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Melhem-Bertrandt, A., Chavez-MacGregor, M., Lei, X., Brown, E. N., Lee, R. T., Meric-Bernstam, F., ... Gonzalez-Angulo, A. M. (2011). Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer. Journal of Clinical Oncology, 29(19), 2645-2652. https://doi.org/10.1200/JCO.2010.33.4441

Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer. / Melhem-Bertrandt, Amal; Chavez-MacGregor, Mariana; Lei, Xiudong; Brown, Erika N.; Lee, Richard T.; Meric-Bernstam, Funda; Sood, Anil K.; Conzen, Suzanne D.; Hortobagyi, Gabriel N.; Gonzalez-Angulo, Ana Maria.

In: Journal of Clinical Oncology, Vol. 29, No. 19, 01.07.2011, p. 2645-2652.

Research output: Contribution to journalArticle

Melhem-Bertrandt, A, Chavez-MacGregor, M, Lei, X, Brown, EN, Lee, RT, Meric-Bernstam, F, Sood, AK, Conzen, SD, Hortobagyi, GN & Gonzalez-Angulo, AM 2011, 'Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer', Journal of Clinical Oncology, vol. 29, no. 19, pp. 2645-2652. https://doi.org/10.1200/JCO.2010.33.4441
Melhem-Bertrandt A, Chavez-MacGregor M, Lei X, Brown EN, Lee RT, Meric-Bernstam F et al. Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer. Journal of Clinical Oncology. 2011 Jul 1;29(19):2645-2652. https://doi.org/10.1200/JCO.2010.33.4441
Melhem-Bertrandt, Amal ; Chavez-MacGregor, Mariana ; Lei, Xiudong ; Brown, Erika N. ; Lee, Richard T. ; Meric-Bernstam, Funda ; Sood, Anil K. ; Conzen, Suzanne D. ; Hortobagyi, Gabriel N. ; Gonzalez-Angulo, Ana Maria. / Beta-blocker use is associated with improved relapse-free survival in patients with triple-negative breast cancer. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 19. pp. 2645-2652.
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abstract = "Purpose: To examine the association between beta-blocker (BB) intake, pathologic complete response (pCR) rates, and survival outcomes in patients with breast cancer treated with neoadjuvant chemotherapy. Patients and Methods: We retrospectively reviewed 1,413 patients with breast cancer who received neoadjuvant chemotherapy between 1995 and 2007. Patients taking BBs at the start of neoadjuvant therapy were compared with patients with no BB intake. Rates of pCR between the groups were compared using a χ2 test. Cox proportional hazards models were fitted to determine the association between BB intake, relapse-free survival (RFS), and overall survival (OS). Results: Patients who used BBs (n = 102) were compared with patients (n = 1,311) who did not. Patients receiving BBs tended to be older and obese (P < .001). The proportion of pCR was not significantly different between the groups (P = .48). After adjustment for age, race, stage, grade, receptor status, lymphovascular invasion, body mass index, diabetes, hypertension, and angiotensin-converting enzyme inhibitor use, BB intake was associated with a significantly better RFS (hazard ratio [HR], 0.52; 95{\%} CI, 0.31 to 0.88) but not OS (P = .09). Among patients with triple-negative breast cancer (TNBC; n = 377), BB intake was associated with improved RFS (HR, 0.30; 95{\%} CI, 0.10 to 0.87; P = .027) but not OS (HR, 0.35; 95{\%} CI, 0.12 to 1.00; P = .05). Conclusion: In this study, BB intake was associated with improved RFS in all patients with breast cancer and in patients with TNBC. Additional studies evaluating the potential benefits of beta-adrenergic blockade on breast cancer recurrence with a focus on TNBC are warranted.",
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AU - Brown, Erika N.

AU - Lee, Richard T.

AU - Meric-Bernstam, Funda

AU - Sood, Anil K.

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AU - Gonzalez-Angulo, Ana Maria

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N2 - Purpose: To examine the association between beta-blocker (BB) intake, pathologic complete response (pCR) rates, and survival outcomes in patients with breast cancer treated with neoadjuvant chemotherapy. Patients and Methods: We retrospectively reviewed 1,413 patients with breast cancer who received neoadjuvant chemotherapy between 1995 and 2007. Patients taking BBs at the start of neoadjuvant therapy were compared with patients with no BB intake. Rates of pCR between the groups were compared using a χ2 test. Cox proportional hazards models were fitted to determine the association between BB intake, relapse-free survival (RFS), and overall survival (OS). Results: Patients who used BBs (n = 102) were compared with patients (n = 1,311) who did not. Patients receiving BBs tended to be older and obese (P < .001). The proportion of pCR was not significantly different between the groups (P = .48). After adjustment for age, race, stage, grade, receptor status, lymphovascular invasion, body mass index, diabetes, hypertension, and angiotensin-converting enzyme inhibitor use, BB intake was associated with a significantly better RFS (hazard ratio [HR], 0.52; 95% CI, 0.31 to 0.88) but not OS (P = .09). Among patients with triple-negative breast cancer (TNBC; n = 377), BB intake was associated with improved RFS (HR, 0.30; 95% CI, 0.10 to 0.87; P = .027) but not OS (HR, 0.35; 95% CI, 0.12 to 1.00; P = .05). Conclusion: In this study, BB intake was associated with improved RFS in all patients with breast cancer and in patients with TNBC. Additional studies evaluating the potential benefits of beta-adrenergic blockade on breast cancer recurrence with a focus on TNBC are warranted.

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