The Influence of Pre-Existing Beta-Blockers Use on Survival Outcomes in HER2 Positive Advanced Breast Cancer: Pooled Analysis of Clinical Trial Data

Natansh D. Modi; Jin Quan Eugene Tan; Andrew Rowland; Bogda Koczwara; Ganessan Kichenadasse; Ross A. McKinnon; Michael D. Wiese; Michael J. Sorich; Ashley M. Hopkins

doi:10.3389/fonc.2020.01130

The Influence of Pre-Existing Beta-Blockers Use on Survival Outcomes in HER2 Positive Advanced Breast Cancer: Pooled Analysis of Clinical Trial Data

Natansh D. Modi, Jin Quan Eugene Tan, Andrew Rowland, Bogda Koczwara, Ganessan Kichenadasse, Ross A. McKinnon, Michael D. Wiese, Michael J. Sorich, Ashley M. Hopkins

College of Medicine and Public Health

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Abstract

Introduction: Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC). Materials and Methods: Data from clinical trials EMILIA, TH3RESA, MARIANNE, and CLEOPATRA was pooled. Cox proportional analysis was used to assess the association between pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapies. Results: Of the 2,777 patients with HER2 positive ABC, 266 were using a BB at the time of anti-HER2 therapy initiation. BB use was associated with worse overall survival (OS) (adjusted HR = 1.27, 95% CI: 1.04–1.55). Sensitivity analysis in patients with pre-existing cardiovascular disease (CVD) also indicated that BB use was associated with worse OS (1.29, 1.02–1.63). Conclusion: In large high-quality data, BB use at the time of anti-HER2 therapy initiation for ABC was independently associated with worse OS, regardless of CVD status. The finding is contrary to pre-study hypotheses and findings in other BC subtypes. Future research should aim to gain a deeper understanding of the effects of BBs on specific BC subtypes, cancer types, and cancer treatments.

Original language	English
Article number	1130
Number of pages	6
Journal	Frontiers in Oncology
Volume	10
DOIs	https://doi.org/10.3389/fonc.2020.01130
Publication status	Published - 14 Jul 2020

Bibliographical note

This is an open-access article distributed under the termsof the Creative Commons Attribution License (CC BY). The use, distribution orreproduction in other forums is permitted, provided the original author(s) and thecopyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. Nouse, distribution orreproduction is permitted which does not comply with these terms

Keywords

beta-blockers
breast cancer
HER2 positive
survival
targeted therapy

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10.3389/fonc.2020.01130Licence: CC BY

Modi_Influence_P2020Final published version, 455 KBLicence: CC BY

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@article{fe465e6a8e1c400b944be615d80f7bf1,

title = "The Influence of Pre-Existing Beta-Blockers Use on Survival Outcomes in HER2 Positive Advanced Breast Cancer: Pooled Analysis of Clinical Trial Data",

abstract = "Introduction: Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC). Materials and Methods: Data from clinical trials EMILIA, TH3RESA, MARIANNE, and CLEOPATRA was pooled. Cox proportional analysis was used to assess the association between pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapies. Results: Of the 2,777 patients with HER2 positive ABC, 266 were using a BB at the time of anti-HER2 therapy initiation. BB use was associated with worse overall survival (OS) (adjusted HR = 1.27, 95% CI: 1.04–1.55). Sensitivity analysis in patients with pre-existing cardiovascular disease (CVD) also indicated that BB use was associated with worse OS (1.29, 1.02–1.63). Conclusion: In large high-quality data, BB use at the time of anti-HER2 therapy initiation for ABC was independently associated with worse OS, regardless of CVD status. The finding is contrary to pre-study hypotheses and findings in other BC subtypes. Future research should aim to gain a deeper understanding of the effects of BBs on specific BC subtypes, cancer types, and cancer treatments.",

keywords = "beta-blockers, breast cancer, HER2 positive, survival, targeted therapy",

author = "Modi, {Natansh D.} and Tan, {Jin Quan Eugene} and Andrew Rowland and Bogda Koczwara and Ganessan Kichenadasse and McKinnon, {Ross A.} and Wiese, {Michael D.} and Sorich, {Michael J.} and Hopkins, {Ashley M.}",

note = "This is an open-access article distributed under the termsof the Creative Commons Attribution License (CC BY). The use, distribution orreproduction in other forums is permitted, provided the original author(s) and thecopyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. Nouse, distribution orreproduction is permitted which does not comply with these terms",

year = "2020",

month = jul,

day = "14",

doi = "10.3389/fonc.2020.01130",

language = "English",

volume = "10",

journal = "Frontiers in Oncology",

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T1 - The Influence of Pre-Existing Beta-Blockers Use on Survival Outcomes in HER2 Positive Advanced Breast Cancer

T2 - Pooled Analysis of Clinical Trial Data

AU - Modi, Natansh D.

AU - Tan, Jin Quan Eugene

AU - Rowland, Andrew

AU - Koczwara, Bogda

AU - Kichenadasse, Ganessan

AU - McKinnon, Ross A.

AU - Wiese, Michael D.

AU - Sorich, Michael J.

AU - Hopkins, Ashley M.

N1 - This is an open-access article distributed under the termsof the Creative Commons Attribution License (CC BY). The use, distribution orreproduction in other forums is permitted, provided the original author(s) and thecopyright owner(s) are credited and that the original publication in this journalis cited, in accordance with accepted academic practice. Nouse, distribution orreproduction is permitted which does not comply with these terms

PY - 2020/7/14

Y1 - 2020/7/14

N2 - Introduction: Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC). Materials and Methods: Data from clinical trials EMILIA, TH3RESA, MARIANNE, and CLEOPATRA was pooled. Cox proportional analysis was used to assess the association between pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapies. Results: Of the 2,777 patients with HER2 positive ABC, 266 were using a BB at the time of anti-HER2 therapy initiation. BB use was associated with worse overall survival (OS) (adjusted HR = 1.27, 95% CI: 1.04–1.55). Sensitivity analysis in patients with pre-existing cardiovascular disease (CVD) also indicated that BB use was associated with worse OS (1.29, 1.02–1.63). Conclusion: In large high-quality data, BB use at the time of anti-HER2 therapy initiation for ABC was independently associated with worse OS, regardless of CVD status. The finding is contrary to pre-study hypotheses and findings in other BC subtypes. Future research should aim to gain a deeper understanding of the effects of BBs on specific BC subtypes, cancer types, and cancer treatments.

AB - Introduction: Beta-blockers (BB) are commonly used to manage cardiovascular disease and may have benefits in controlling complications of anti-HER2 therapies. This study aimed to evaluate the association of pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapy for advanced breast cancer (ABC). Materials and Methods: Data from clinical trials EMILIA, TH3RESA, MARIANNE, and CLEOPATRA was pooled. Cox proportional analysis was used to assess the association between pre-existing BB use with survival outcomes in patients initiating anti-HER2 therapies. Results: Of the 2,777 patients with HER2 positive ABC, 266 were using a BB at the time of anti-HER2 therapy initiation. BB use was associated with worse overall survival (OS) (adjusted HR = 1.27, 95% CI: 1.04–1.55). Sensitivity analysis in patients with pre-existing cardiovascular disease (CVD) also indicated that BB use was associated with worse OS (1.29, 1.02–1.63). Conclusion: In large high-quality data, BB use at the time of anti-HER2 therapy initiation for ABC was independently associated with worse OS, regardless of CVD status. The finding is contrary to pre-study hypotheses and findings in other BC subtypes. Future research should aim to gain a deeper understanding of the effects of BBs on specific BC subtypes, cancer types, and cancer treatments.

KW - beta-blockers

KW - breast cancer

KW - HER2 positive

KW - survival

KW - targeted therapy

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U2 - 10.3389/fonc.2020.01130

DO - 10.3389/fonc.2020.01130

M3 - Article

AN - SCOPUS:85089008821

SN - 2234-943X

VL - 10

JO - Frontiers in Oncology

JF - Frontiers in Oncology

M1 - 1130

ER -

The Influence of Pre-Existing Beta-Blockers Use on Survival Outcomes in HER2 Positive Advanced Breast Cancer: Pooled Analysis of Clinical Trial Data

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