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Beta-Blocker Drug Use and Survival among Patients with Pancreatic Adenocarcinoma
Örebro University, School of Medical Sciences. Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.ORCID iD: 0000-0001-6328-5494
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Cardiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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2017 (English)In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 77, no 13, 3700-3707 p.Article in journal (Refereed) Published
Abstract [en]

Preclinical studies have suggested that beta-adrenergic signaling is involved in pancreatic cancer progression. Prompted by such studies, we investigated an association between beta-blocker drug use with improved cancer-specific survival in a large, general population-based cohort of patients with pancreatic ductal adenocarcinoma (PDAC). All patients diagnosed with a first primary PDAC in Sweden between 2006 and 2009 were identified through the Swedish Cancer Register (n = 2,394). We obtained information about use of beta-blockers and other medications through linkage with the national Prescribed Drug Register. Cancer-specific mortality was assessed using the Swedish Cause of Death Register. We used multivariable Cox regression adjusted for sociodemographic factors, tumor characteristics, comorbidity score, and other medications to estimate HRs and 95% confidence intervals (CI) for cancer-specific mortality associated with beta-blocker use during the 90-day period before cancer diagnosis. A total of 2,054 (86%) died, with pancreatic cancer recorded as the underlying cause of death during a maximum of 5-year follow-up (median 5 months). Patients who used beta-blockers (n = 522) had a lower cancer-specific mortality rate than nonusers (adjusted HR, 0.79; 95% CI, 0.70-0.90; P < 0.001). This observed rate reduction was more pronounced among patients with localized disease at diagnosis (n = 517; adjusted HR, 0.60; 95% CI, 0.43-0.83; P = 0.002), especially for users with higher daily doses (HR, 0.54; 95% CI, 0.35-0.83; P = 0.005). No clear rate differences were observed by beta-blocker receptor selectivity. Our results support the concept that beta-blocker drugs may improve the survival of PDAC patients, particularly among those with localized disease.

Place, publisher, year, edition, pages
American Association for Cancer Research Inc. , 2017. Vol. 77, no 13, 3700-3707 p.
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
URN: urn:nbn:se:oru:diva-58937DOI: 10.1158/0008-5472.CAN-17-0108ISI: 000404718400028PubMedID: 28473530Scopus ID: 2-s2.0-85023745947OAI: oai:DiVA.org:oru-58937DiVA: diva2:1134629
Funder
Swedish Cancer Society, CAN 2013/650
Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2017-09-19Bibliographically approved

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Udumyan, RuzanMontgomery, ScottFall, Katja

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