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Geburtshilfe Frauenheilkd 2016; 76(10): 1050-1056
DOI: 10.1055/s-0042-115016
Review
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

The Clinical Relevance of Beta Blockers in Ovarian Carcinoma

A Systematic ReviewKlinische Relevanz von β-Blockern beim OvarialkarzinomEin systematischer Review
J. Hefner
Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
,
H. Csef
Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
› Author Affiliations
Further Information

Publication History

received 23 March 2016
revised 03 August 2016

accepted 03 August 2016

Publication Date:
14 October 2016 (online)

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Abstract

The last ten years have seen hardly any improvement in the prognosis of ovarian carcinoma. There is a great need for new treatment strategies, and a recent retrospective study showing a survival advantage with the use of beta blockers met with a very positive response. This systematic review summarizes the current state of knowledge and research on the topic: A database analysis identified six clinical studies showing inconsistent results with respect to the administration of beta blockers and disease course. The 13 preclinical studies identified showed almost without exception both that catecholamines had detrimental effects on tumour progression, and that these effects could be influenced by pharmacological blockade. Overall the available evidence does not justify the use of beta blockers in clinical practice for ovarian carcinoma at the present time. This article also outlines details of research design required for further studies needed on the subject. Preclinical research findings are however very impressive: They not only form an important basis for the development of future clinical studies but also, through revealing new pathomechanisms, they already make an important contribution towards the development of new treatment strategies for ovarian carcinoma.

Zusammenfassung

Die Prognose des Ovarialkarzinoms konnte in den letzten Jahrzehnten kaum verbessert werden. Der Wunsch nach neuen Therapiestrategien ist daher sehr groß und eine aktuelle retrospektive Studie zum Überlebensvorteil durch Einnahme von β-Blockern erzeugte große Resonanz. Diese systematische Übersicht soll den aktuellen Forschungsstand zum Thema zusammenfassen. In einer Datenbankrecherche konnten 6 klinische Arbeiten zusammengetragen werden, die in Bezug auf die Gabe von β-Blockern und den Krankheitsverlauf inkonsistente Ergebnisse zeigen. Die 13 gefundenen präklinischen Studien zeigen dagegen fast ausnahmslos ungünstige Einflüsse von Katecholaminen auf das Tumorgeschehen sowie die Möglichkeit der pharmakologischen Blockade dieser Einflüsse. In der Zusammenschau rechtfertigen die bisherigen Ergebnisse eine klinische Anwendung von β-Blockern beim Ovarialkarzinom zum jetzigen Zeitpunkt nicht. Es werden weitere Studien benötigt, deren Spezifika zum Forschungsdesign im Text erläutert werden. Die Ergebnisse der präklinischen Daten sind dagegen sehr eindrucksvoll und bilden nicht nur eine wichtige Basis für die Entwicklung zukünftiger klinischer Studien. Mit der Aufklärung neuer Pathomechanismen leisten sie bereits jetzt einen sehr wichtigen Beitrag bei der Arbeit an neuen Therapiestrategien gegen das Ovarialkarzinom.

Key words

ovarian cancer - metastasis - molecular pathway - β-adrenergic signaling - β-Blocker - hallmarks of cancer

Schlüsselwörter

Ovarialkarzinom - Metastase - molekulare Signalwege - β-adrenergische Signalgebung - β-Blocker - Kennzeichen von Krebs

Supporting Information

 

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