Impact of beta-blockers on cancer recurrence and survival: A systematic
review and meta-analysis
Abstract
Background: Beta-blockers are frequently used anti-hypertensive
agents. It has been proposed that beta-blocker usage can potentially
impact outcomes among cancer patients. While there is existing
literature on the matter, studies have yielded conflicting results. The
aim of this systemic review and meta-analysis is to further investigate
the effect of beta-blockers on survival and recurrence among those
diagnosed with cancer. Methods: We systematically searched
PubMed, Web of Science, Embase, and Cochrane Library for relevant
studies published until October 16 th, 2023. Hazard
ratios (HR) and their corresponding 95% confidence intervals were
extracted from the studies. Subgroup analysis and sensitivity analysis
were performed to investigate heterogeneity and make results more
reliable. Results: Data from fifty-four studies was included in
this meta-analysis. A subgroup analysis was conducted based on the type
of beta blockers and the type of cancer to assess the overall survival
(OS) outcome. It was found that beta-blockers had no significant impact
on overall survival, based on the type of cancer (HR=0.99; 95% CI:
0.94-1.04; P=0.70), and the type of beta-blockers (HR=0.99; 95% CI:
0.91-1.04; P=0.23). However, statistically significant results were
observed for the outcome of cancer recurrence, favoring the beta-blocker
group over the control group. A sensitivity analysis was conducted on
both the outcomes to assess the heterogeneity in the results, reducing
it considerably. Conclusion: According to our results, it can
be concluded that the usage of beta-blockers generally has no
significant impact on survival outcomes, however, a positive impact on
recurrence was observed. There was a downward, yet non-significant,
trend in pancreatic and ovarian cancer, indicating that further studies
should investigate this.