Add-on metoprolol of no benefit to high-risk prostate cancer patients

Use of metoprolol among high-risk prostate cancer (PCa) patients receiving androgen deprivation therapy (ADT) does not appear to improve oncological outcomes, as shown in a study.

The study used data from the National Veterans Health Administration database and identified men diagnosed with high-risk PCa (prostate-specific antigen [PSA] >20) who were on ADT for ≥6 months. Those who received ADT concurrently with primary radiation therapy were excluded.

Researchers examined pharmacy data for all beta-blockers and the selective beta-1 blocker metoprolol. They applied Cox proportional hazards ratios to estimate overall survival (OS), prostate cancer-specific survival (CSS), and skeletal-related events (SREs) in relation to metoprolol use.

A total of 39,198 patients with high-risk PCa on ADT comprised the study population. Use of any beta-blocker did not yield improvements in OS, CSS, and SREs.

An analysis that focused on metoprolol involved 10,224 (31.9 percent) users and 21,834 who did not use any beta-blockers. Multivariable Cox models with inverse propensity score weighting showed that metoprolol users did not fare better than nonusers of beta-blockers in terms of all oncological outcomes examined: OS (hazard ratio [HR], 0.97; p=0.19), CSS (HR, 0.94; p=0.23) or SREs (HR, 0.98; p=0.79).

Factors such as PSA, Gleason score, and duration of ADT were included in the analysis as confounders.

The present data show that there is no cancer-specific benefit to using a beta-blocker in advanced prostate cancer.