Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Chris R Cardwell; Anton Pottegård; Evelien Vaes; Hans Garmo; Liam J Murray; Chris Brown; Pauline A J Vissers; Michael O'Rorke; Kala Visvanathan; Deirdre Cronin-Fenton; Harlinde De Schutter; Mats Lambe; Des G Powe; Myrthe P P van Herk-Sukel; Anna Gavin; Søren Friis; Linda Sharp; Kathleen Bennett

doi:10.1186/s13058-016-0782-5

Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Chris R Cardwell
, Anton Pottegård
, Evelien Vaes
, Hans Garmo
, Liam J Murray
, Chris Brown
, Pauline A J Vissers
, Michael O'Rorke
, Kala Visvanathan
, Deirdre Cronin-Fenton
, Harlinde De Schutter
, Mats Lambe
, Des G Powe
, Myrthe P P van Herk-Sukel
, Anna Gavin
, Søren Friis
, Linda Sharp
, Kathleen Bennett

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Preclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.

METHODS: Incident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose-response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.

RESULTS: The combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95% CI, 0.77, 1.16 and HR = 1.09, 95% CI, 0.93, 1.28, respectively). There was little evidence of a dose-response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95% CI, 0.86, 1.22 and HR = 1.02, 95% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.

CONCLUSIONS: In this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.

Original language	English
Pages (from-to)	119
Journal	Breast Cancer Research
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s13058-016-0782-5
Publication status	Published - 1 Dec 2016
Externally published	Yes

Keywords

Journal Article

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10.1186/s13058-016-0782-5

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Cardwell, C. R., Pottegård, A., Vaes, E., Garmo, H., Murray, L. J., Brown, C., Vissers, P. A. J., O'Rorke, M., Visvanathan, K., Cronin-Fenton, D., De Schutter, H., Lambe, M., Powe, D. G., van Herk-Sukel, M. P. P., Gavin, A., Friis, S., Sharp, L., & Bennett, K. (2016). Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts. Breast Cancer Research, 18(1), 119. https://doi.org/10.1186/s13058-016-0782-5

@article{015535ea9a0e41309b7dc6621ff1894d,

title = "Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts",

abstract = "BACKGROUND: Preclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.METHODS: Incident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95\% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose-response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.RESULTS: The combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95\% CI, 0.77, 1.16 and HR = 1.09, 95\% CI, 0.93, 1.28, respectively). There was little evidence of a dose-response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95\% CI, 0.86, 1.22 and HR = 1.02, 95\% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.CONCLUSIONS: In this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.",

keywords = "Journal Article",

author = "Cardwell, \{Chris R\} and Anton Potteg{\aa}rd and Evelien Vaes and Hans Garmo and Murray, \{Liam J\} and Chris Brown and Vissers, \{Pauline A J\} and Michael O'Rorke and Kala Visvanathan and Deirdre Cronin-Fenton and \{De Schutter\}, Harlinde and Mats Lambe and Powe, \{Des G\} and \{van Herk-Sukel\}, \{Myrthe P P\} and Anna Gavin and S{\o}ren Friis and Linda Sharp and Kathleen Bennett",

year = "2016",

month = dec,

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doi = "10.1186/s13058-016-0782-5",

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journal = "Breast Cancer Research",

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Cardwell, CR, Pottegård, A, Vaes, E, Garmo, H, Murray, LJ, Brown, C, Vissers, PAJ, O'Rorke, M, Visvanathan, K, Cronin-Fenton, D, De Schutter, H, Lambe, M, Powe, DG, van Herk-Sukel, MPP, Gavin, A, Friis, S, Sharp, L & Bennett, K 2016, 'Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts', Breast Cancer Research, vol. 18, no. 1, pp. 119. https://doi.org/10.1186/s13058-016-0782-5

TY - JOUR

T1 - Propranolol and survival from breast cancer

T2 - a pooled analysis of European breast cancer cohorts

AU - Cardwell, Chris R

AU - Pottegård, Anton

AU - Vaes, Evelien

AU - Garmo, Hans

AU - Murray, Liam J

AU - Brown, Chris

AU - Vissers, Pauline A J

AU - O'Rorke, Michael

AU - Visvanathan, Kala

AU - Cronin-Fenton, Deirdre

AU - De Schutter, Harlinde

AU - Lambe, Mats

AU - Powe, Des G

AU - van Herk-Sukel, Myrthe P P

AU - Gavin, Anna

AU - Friis, Søren

AU - Sharp, Linda

AU - Bennett, Kathleen

PY - 2016/12/1

Y1 - 2016/12/1

N2 - BACKGROUND: Preclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.METHODS: Incident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose-response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.RESULTS: The combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95% CI, 0.77, 1.16 and HR = 1.09, 95% CI, 0.93, 1.28, respectively). There was little evidence of a dose-response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95% CI, 0.86, 1.22 and HR = 1.02, 95% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.CONCLUSIONS: In this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.

AB - BACKGROUND: Preclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.METHODS: Incident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose-response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.RESULTS: The combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95% CI, 0.77, 1.16 and HR = 1.09, 95% CI, 0.93, 1.28, respectively). There was little evidence of a dose-response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95% CI, 0.86, 1.22 and HR = 1.02, 95% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.CONCLUSIONS: In this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.

KW - Journal Article

U2 - 10.1186/s13058-016-0782-5

DO - 10.1186/s13058-016-0782-5

M3 - Article

C2 - 27906047

SN - 1465-5411

VL - 18

SP - 119

JO - Breast Cancer Research

JF - Breast Cancer Research

IS - 1

ER -

Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

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