medwireNews: Taking nonselective, but not selective, beta blockers at the time of radical prostatectomy may decrease the risk for prostate cancer recurrence, findings indicate.
Men using nonselective beta blockers were significantly less likely than nonusers to initiate treatment for disease recurrence, report Kristin Austlid Taskén and colleagues from Oslo University Hospital in Norway.
“This finding, together with accumulated preclinical and clinical evidence, provides a foundation for initiation of an interventional study,” they write in JAMA Network Open.
The study included data from the Cancer Registry of Norway, Norwegian Patient Registry, Norwegian Prescription Database, and Norwegian Cause of Death Registry on 11,117 treatment-naïve men who underwent radical prostatectomy in 2008–2015 and had at least 6 months of progression-free follow-up.
A total of 209 men were considered users of nonselective beta blockers as they had filled a prescription in the 100 days before surgery, most commonly for carvedilol (56.9%) and propranolol (25.4%), while 1511 were users of selective beta blockers.
After adjusting for multiple confounders, nonselective beta blocker use was associated with a significant 36% reduced likelihood of initiating hormonal therapy, radiotherapy, or chemotherapy for prostate cancer, or prostate cancer-specific death in a dataset using imputed data for missing covariates.
The risk for treatment for recurrence was a significant 49% lower for nonselective beta blocker users versus nonusers in a dataset including just the 7147 cases with complete data.
By contrast, selective beta blockers were not associated with a reduced likelihood of treatment for recurrence in either the imputed or complete case dataset.
“The β2-AR [adrenergic receptor] has been identified as the key adrenergic receptor over β1-AR, promoting catecholamine-induced tumorigenesis,” say the researchers.
They continue: “This finding could explain why an association with prostate cancer progression was only observed for [nonselective beta blockers], which act on both β1- and β2-ARs, and not for [selective beta blockers], which target mainly β1-AR.”
And the team concludes: “With the high volumes of [radical prostatectomies] being performed, even a small delay in the need for further hormonal therapy and radiotherapy after surgery would justify an interventional study to identify a potential causality between [nonselective beta blocker] use and prostate cancer recurrence.”
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