Background/Objectives: Beta adrenergic signaling has been implicated in cancer progression, leading to interest in repurposing beta blockers (BBs) as adjunctive anti-cancer agents. However, clinical findings are inconsistent. This systematic review and meta-analysis evaluates the association between BB use and survival outcomes in cancer patients. Methods: A systematic search of OVID Medline, EMBASE, and CENTRAL was conducted through 13 September 2023, for studies comparing survival outcomes in solid tumor patients using BBs versus non-users. Eligible studies reported hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS), or cancer-specific survival (CSS). Perioperative studies and those without BB-specific HRs were excluded. Data extraction and quality assessment were performed in duplicate using ROBINS-I. A random-effects model was used, with heterogeneity assessed by the I2statistic. Results: Seventy-nine studies (492,381 patients) met the inclusion criteria; 2.5% were prospective. The most frequently studied cancers were breast (n= 33), ovarian (n= 30), and colorectal (n= 28). BB use was associated with improved PFS (HR 0.78, 95% CI: 0.66–0.92, I2= 79.8%), with significance maintained after excluding high-bias studies (HR 0.74, 95% CI: 0.61–0.91, I2= 36.6%). No significant associations were observed for OS (HR 0.99, 95% CI: 0.94–1.04, I2= 84.9%) or CSS (HR 0.95, 95% CI: 0.91–1.00, I2= 77.4%). Conclusions: BB use may be associated with longer PFS in cancer patients, but findings are limited by study design and heterogeneity; high-quality prospective studies are needed.
背景/目的：β肾上腺素能信号通路被认为与癌症进展相关，这引发了人们对将β受体阻滞剂（BBs）重新用作辅助抗癌药物的兴趣。然而，临床研究结果并不一致。本系统综述与荟萃分析旨在评估癌症患者使用β受体阻滞剂与生存结局之间的关联。方法：截至2023年9月13日，系统检索了OVID Medline、EMBASE和CENTRAL数据库，纳入比较实体瘤患者使用与未使用β受体阻滞剂生存结局的研究。符合条件的研究需报告总生存期（OS）、无进展生存期（PFS）或癌症特异性生存期（CSS）的风险比（HRs）。排除了围手术期研究及未提供β受体阻滞剂特异性风险比的研究。采用ROBINS-I工具进行重复数据提取和质量评估，并使用随机效应模型进行荟萃分析，通过I²统计量评估异质性。结果：共79项研究（492,381例患者）符合纳入标准，其中2.5%为前瞻性研究。研究最多的癌症类型为乳腺癌（33项）、卵巢癌（30项）和结直肠癌（28项）。β受体阻滞剂的使用与改善的PFS相关（HR 0.78，95% CI：0.66–0.92，I²= 79.8%），在排除高偏倚研究后该关联仍保持显著（HR 0.74，95% CI：0.61–0.91，I²= 36.6%）。未观察到β受体阻滞剂使用与OS（HR 0.99，95% CI：0.94–1.04，I²= 84.9%）或CSS（HR 0.95，95% CI：0.91–1.00，I²= 77.4%）存在显著关联。结论：β受体阻滞剂的使用可能与癌症患者更长的PFS相关，但该结论受研究设计和异质性的限制，仍需高质量的前瞻性研究加以验证。
The Impact of Beta Blockers on Survival in Cancer Patients: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家