Beta-Blockers May Lower PCa Mortality in High-Risk Patients

Beta-blocker use by men with high-risk or metastatic prostate cancer (PCa) is associated with a decreased risk of PCa-specific mortality, a new study suggests.

The study, led by Kristin Austlid Taskén, PhD, Adjunct Professor in the Department of Urology at Oslo University Hospital in Norway, examined the association between beta-blocker use and PCa-specific mortality in a cohort of 3,561 PCa patients with high-risk or metastatic disease at the time of diagnosis. After a median follow-up of 39 months, the researchers found that subjects who used beta-blockers had a 21% decreased risk of PCa-specific mortality compared with non-users in adjusted analyses, according to a report published online ahead of print in European Urology. The association was independent of statin and aspirin use as well as clinical characteristics at diagnosis. In addition, the study found no association between beta-blocker use and all-cause mortality.

The authors cited animal studies showing that beta-blockers can inhibit the development of metastases from breast cancer and PCa. In addition, epidemiologic evidence suggests a survival benefit of beta-blocker use among breast cancer patients.

Dr. Taskén's group noted that the typical beta-blocker user is frequently also treated with other drugs to prevent cardiac events, such as low-dose aspirin and statins. Previous studies have found that use of aspirin or statins is associated with improved outcomes in PCa patients. For example, a study found that aspirin use was associated with a decreased risk of PCa-specific mortality among PCa patients treated with radical prostatectomy or radiotherapy (J Clin Oncol 2012;30:3540-3544). Another study showed that statin use by PCa patients treated with radiotherapy was associated with a decreased risk of biochemical recurrence and improved relapse-free survival (J Clin Oncol 2010;28:2653-2659).

The study by Dr. Taskén and colleagues addressed the potential confounding that could result from patients' use of these drug classes.

Of the 3,561 patients in the study, 1,115 (31.3%) used a beta-blocker both before and after their PCa diagnosis. Beta-blocker users were significantly older than non-users at the time of diagnosis (77.2 vs. 75.9 years), and they were more frequently users of statins (52.6% vs. 13.9%) and aspirin (57.1% vs. 20.9%).

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