Effect of β-Blocker in Treatment-Naïve Patients With Advanced Lung Adenocarcinoma Receiving First-Generation EGFR-TKIs.
Effect of β-Blocker in Treatment-Naïve Patients With Advanced Lung Adenocarcinoma Receiving First-Generation EGFR-TKIs.
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β受体阻滞剂在接受第一代EGFR-TKIS的晚期肺腺癌患者中的影响。
DOI：
10.3389/fonc.2020.583529
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发表时间：
2020
影响因子：
4.7
通讯作者：
Yu CJ
中科院分区：
文献类型：
--
作者：
Chang CH;Lee CH;Ko JC;Chang LY;Lee MC;Zhang JF;Wang JY;Shih JY;Yu CJ
慢性应激通过激活肾上腺素能受体，触发神经递质和激素的分泌，促进肿瘤生长，增加血管生成，促进耐药。本研究旨在评估β受体阻滞剂在接受一线表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗肺腺癌患者中的作用。在高血压或缺血性心脏病亚组中，使用β受体阻滞剂（定义为在开始EGFR-TKI治疗前180天内每日剂量≥60）对EGFR-TKI的2年停药时间（TTD）和4年总生存率（OS）的影响，采用Cox回归分析、逆倾向评分加权和敏感性分析。在4988例入组患者中，552例（11.1%）属于β受体阻滞剂组。β受体阻滞剂组的患者更可能年龄在75岁以上，并且有糖尿病和心血管合并症。在Cox回归分析中，β受体阻滞剂的使用与较长的TTD（风险比，HR: 0.91[0.86-0.96]）和OS （HR: 0.68[0.64-0.72]）相关。敏感性分析结果也倾向于β受体阻滞剂组。在接受一线EGFR-TKIs治疗的treatment-naïve晚期肺腺癌患者中，先前使用β-阻滞剂与更好的预后相关。这些发现鼓励进一步的前瞻性临床研究来验证β受体阻滞剂作为辅助抗癌治疗的可能性。
Through activation of adrenergic receptors, chronic stress can trigger the secretion of neurotransmitters and hormones that enhance tumor growth, increase angiogenesis, and promote drug resistance. This study aimed to evaluate the effect of β-blockers in patients receiving first-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for lung adenocarcinoma. This retrospective cohort study enrolled patients with advanced lung adenocarcinoma under first-line EGFR-TKIs between 2011 and 2014 in the National Health Insurance Research Database of Taiwan. The effects of β-blockers use, defined as ≥60 defined daily doses within 180 days before initiation of EGFR-TKI therapy, on the 2-year time-to-discontinuation (TTD) of EGFR-TKIs and 4-year overall survival (OS) were investigated using Cox regression analyses with inverse propensity score weighting and sensitivity analysis in subgroup with either hypertension or ischemic heart diseases. Among 4988 enrolled patients, 552 (11.1%) were in the β-blocker group. Patients in the β-blocker group were more likely to be older than 75 and had diabetes mellitus and cardiovascular comorbidities. In Cox regression analysis, β-blocker usage was associated with a longer TTD (hazard ratio, HR: 0.91 [0.86–0.96]) and OS (HR: 0.68 [0.64–0.72]). The results also favored β-blocker group in sensitivity analysis. In treatment-naïve patients with advanced lung adenocarcinoma under first-line EGFR-TKIs, prior use of β-blocker was associated with a better outcome. The findings encourage further prospective clinical study to validate the possibility of β-blockers as adjuvant anticancer therapy.
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影响因子：
4.7
作者：
Braadland PR;Ramberg H;Grytli HH;Taskén KA
通讯作者：
Taskén KA
影响因子：
6.4
作者：
Banerjee J;Papu John AM;Schuller HM
通讯作者：
Schuller HM
影响因子：
17.1
作者：
Nilsson MB;Sun H;Diao L;Tong P;Liu D;Li L;Fan Y;Poteete A;Lim SO;Howells K;Haddad V;Gomez D;Tran H;Pena GA;Sequist LV;Yang JC;Wang J;Kim ES;Herbst R;Lee JJ;Hong WK;Wistuba I;Hung MC;Sood AK;Heymach JV
通讯作者：
Heymach JV
影响因子：
45.3
作者：
Sperduto, Paul W.;Kased, Norbert;Mehta, Minesh
通讯作者：
Mehta, Minesh
影响因子：
158.5
作者：
Soria, J. -C.;Ohe, Y.;Nguyen, Nhung
通讯作者：
Nguyen, Nhung