Abstract Details

Title A Survival Analysis of Beta-blocker Administration for Cardiovascular Disease in Patients With Glioblastoma

Topic Neuro-oncology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-001

Objective We investigated whether the use of beta-blockers (BB) for cardiovascular disease (CVD) yields progression free survival (PFS) and overall survival (OS) benefit in glioblastoma (GBM) patients.

Background Patients are prescribed BB to manage CVD. Proposed BB benefits in GBM include antagonism of tumor-induced sympathetic hyperactivity, believed to enhance tumor cell proliferation. Understanding survival metrics of GBM cohorts taking BB may clarify whether BB confers survival benefits.

Design/Methods Single institution retrospective review yielded 523 patients diagnosed with GBM; 119 were prescribed BB outpatient while receiving treatment for their GBM. Acute disease management with BB was excluded. CVD included hypertension, cerebrovascular disease, arrythmias, or congestive heart failure. Kaplan Meier modeling characterized OS and PFS. Multivariable Cox proportional hazard models assessed survival for patients with (119) and without BB (404), corrected for age, sex, race, chemotherapy, radiotherapy, and surgery.

Results GBM patients taking BB displayed lower median PFS and OS (4.4 vs. 6.3 months; 8.1 vs. 13.2 months, respectively), increased risk of progression (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.2-1.8; p<0.001), and death (HR, 1.5; 95% CI, 1.2-1.9; p<0.001) compared to those not taking BB. Increased risk of death in GBM patients was also associated with CVD (HR, 1.7; 95% CI, 1.4-2.0, p<0.001) and higher age (HR, 1.03; 95% CI, 1.02-1.04; p<0.001). Within the CVD cohort, GBM patients taking BB demonstrated rapid progression (HR, 1.2; 95% CI, 0.97-1.6; p<0.10), death (HR, 1.2; 95% CI, 0.96-1.6; p<0.10), and worse median OS (7.5 vs. 9.2 months) than those with CVD but not taking BB.

Conclusions CVD is associated with risk of progression and shorter survival in GBM patients. However, the hypothesized benefit of BB use on GBM survival was not replicated in either the full GBM cohort or within the CVD subset.

Authors/Disclosures
Joshua Hanlon, MS PRESENTER	Mr. Hanlon has nothing to disclose.
Ryan Rilinger	Mr. Rilinger has nothing to disclose.
Mark G. Malkin, MD, FAAN (CLEVELAND CLINIC)	Dr. Malkin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Worldwide Clinical Trials. Dr. Malkin has received publishing royalties from a publication relating to health care.
Gene H. Barnett, MD	Dr. Barnett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical. Dr. Barnett has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Monteris Medical.
David M. Peereboom, MD	Dr. Peereboom has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Anheart. Dr. Peereboom has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeOnc. Dr. Peereboom has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Peereboom has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Orbus. Dr. Peereboom has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Servier. The institution of Dr. Peereboom has received research support from Nuvation. The institution of Dr. Peereboom has received research support from Anheart. The institution of Dr. Peereboom has received research support from Pfizer. The institution of Dr. Peereboom has received research support from NeOnc. The institution of Dr. Peereboom has received research support from Bristol-Myers Squibb. The institution of Dr. Peereboom has received research support from Genentech/Roche. The institution of Dr. Peereboom has received research support from Orbus. The institution of Dr. Peereboom has received research support from GCAR.

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