Kocak Mehmet Zahid, Er Muhiddin, Ugrakli Muzaffer, Hendem Engin, Araz Murat, Eryilmaz Melek Karakurt, Artac Mehmet
Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Eur J Clin Pharmacol. 2023 Apr;79(4):485-491. doi: 10.1007/s00228-023-03464-w. Epub 2023 Feb 7.
Drug-drug interactions are sometimes neglected in oncology practice. Due to drug pharmacokinetic and pharmacodynamic interactions, clinically increased or decreased drug effects and increased or decreased adverse effects may occur. Considering that the concomitant use of these two drugs that affect vascular endothelial growth factor receptor (VEGFR) may cause pharmacological potentiation or additive interaction, we aimed to evaluate the survival outcomes of concomitant use of bevacizumab and beta blockers in patients with metastatic colorectal cancer (mCRC).
In total, 181 patients with mCRC administered with bevacizumab plus cytotoxic chemotherapy regimen in a first-line setting were divided into two groups: concomitant beta-blocker user and nonuser.
The median overall survival (mOS) was 35.9 (95% CI: 27.9-43.9) months in the beta-blocker-using group and 29.6 (95% CI: 27.9-43.9) months in the beta-blocker-non-using group (p = 0.054). The median progression-free survival (mPFS) was 16.1 (95% CI: 12.4-19.9) months in the beta-blocker-using group and 12.8 (95% CI: 10.6-15.0) months in the beta-blocker-non-using group (p = 0.006). The multivariate analysis revealed that beta-blocker use was an independent predictor of mPFS (HR: 0.66, 95% CI: 0.46-0.93, p = 0.018) and mOS (HR: 0.57, 95% CI: 0.36-0.91, p = 0.02).
This study demonstrated that concomitant usage of beta blockers improved both survival outcomes, irrespective of the kind of beta blocker.
药物相互作用在肿瘤学实践中有时会被忽视。由于药物的药代动力学和药效学相互作用，临床上可能会出现药物效果增强或减弱以及不良反应增加或减少的情况。鉴于同时使用这两种影响血管内皮生长因子受体（VEGFR）的药物可能会导致药理增强或相加相互作用，我们旨在评估转移性结直肠癌（mCRC）患者同时使用贝伐单抗和β受体阻滞剂的生存结局。
总共181例在一线治疗中接受贝伐单抗加细胞毒性化疗方案的mCRC患者被分为两组：同时使用β受体阻滞剂组和未使用β受体阻滞剂组。
使用β受体阻滞剂组的中位总生存期（mOS）为35.9（95%CI：27.9 - 43.9）个月，未使用β受体阻滞剂组为29.6（95%CI：27.9 - 43.9）个月（p = 0.054）。使用β受体阻滞剂组的中位无进展生存期（mPFS）为16.1（95%CI：12.4 - 19.9）个月，未使用β受体阻滞剂组为12.8（95%CI：10.6 - 15.0）个月（p = 0.006）。多变量分析显示，使用β受体阻滞剂是mPFS（HR：0.66，95%CI：0.46 - 0.93，p = 0.018）和mOS（HR：0.57，95%CI：0.36 - 0.91，p = 0.02）的独立预测因素。
本研究表明，无论β受体阻滞剂的种类如何，同时使用β受体阻滞剂均可改善生存结局。
