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Table 1 Cohort studies of aspirin, beta-blockers, angiontensin-converting enzyme inhibitors, statins, and metformin and breast cancer survival

From: Hiding in plain view: the potential for commonly used drugs to reduce breast cancer mortality

Authors (year)

Study population

Number

Number taking drug (percentage)

Years of follow-up

Recurrence RR (95% CI)

Breast cancer mortality RR (95% CI)

Total mortality RR (95% CI)

Aspirin

Kwan et al. [10]

(2007)

LACE cohort, stages I-IIIA, with linked pharmacy records

2,292

-

Mean 2.5

1.09a (0.74-1.61)

-

-

Blair et al. [11]

(2007)

Iowa Women's Health Study, post-menopausal

591

-

Maximum 9.5

-

0.53

(0.30-0.93)

0.53

(0.36-0.79)

Holmes et al. [12]

(2010)

Nurses' Health Study, stages I-III

4,164

(48% of the person-time)

Maximum 30

-

0.51

(0.41-0.65)

-

Li et al. [14]

(2012)

Cases from a population-based case control study followed as a cohort

1,024

-

Mean 7.3

-

0.89

(0.52-1.52)

0.82

(0.54-1.24)

Beta-blockers

       

Powe et al. [21]

(2010)

UK, stages I-III

466

43 (9%)

Mean 10.3

0.43b

(0.20-0.93)

0.29

(0.12-0.71)

-

Melhem-Bertrandt et al. [22]

(2011)

MD Anderson triple-negative stages I-III

1,413

102 (7%)

Median 4.6

0.52a

(0.31-0.88)

-

0.64

(0.38-1.07)

Ganz et al. [23]

(2011)

LACE cohort, stages I-IIIA, with linked pharmacy records

1,779

270 (15%)

Mean 8.2

0.86a

(0.57-1.32)

0.76

(0.44-1.33)

1.04

(0.72-1.51)

Barron et al. [24] (2011)

Nested case control linked Irish cancer and pharmacy registries, stages I-IV

5,333

Propranolol = 70

Median 3.5

-

0.19

(0.06-0.60)

--

   

Atenolol = 525 (matched 1:2)

  

1.16

(0.84-1.61)

-

Angiotensin-converting enzyme inhibitors (ACEIs) and angiontensin type I receptor blockers (ARBs)

Melhem-Bertrandt et al. [22] (2011)

MD Anderson triple-negative stages I-III

1,413

140 (10%)c

Median 4.6

0.82a

(0.54-1.26)

-

0.99

(0.65-1.51)

Ganz et al. [23] (2011)

LACE cohort, stages I-IIIA, with linked pharmacy records

1,779

137 (8%)d

Mean 8.2

1.56a

(1.02-2.39)

1.27

(0.74-2.19)

1.23

(0.82-1.83)

Chae et al. [30] (2011)

Stage II/III hospital patients

703

168 (24%)

Median 4.6

0.49a

(0.31-0.76)

-

NS

Statins

Kwan et al. [33]

(2008)

LACE cohort, stages I-IIIA, with linked pharmacy records

1,811

367 (20%)

Mean 5.0

0.67a

(0.39-1.13)

-

-

Ahern et al. [34]

(2011)

Danish registry cohort with linked pharmacy records, stages I-III

18,769

140 (10%)c

Median 6.8

0.83a

(0.70-0.98)

-

-

Chae et al. [30]

(2011)

Stage II/III hospital patients

703

156 (22%)

Median 4.6

0.40a

(0.24-0.67)

-

NS

Metformin

       

He et al. [42]

(2012)

MD Anderson HER2-positive stages II-IV

1,983

66 (3.3%)

Median 4.0

-

0.47

(0.24-0.90)

0.52

(0.28-0.97)

Bayraktar et al. [46]

(2012)

MD Anderson, triple-negative on adjuvant chemotherapy, stages I-III

1,448

63 (4.4%)

meformin, 67 (4.6%) on other anti-diabetics

Median 5.2

1.63b

(0.87-3.06)

for diabetics not on metformin, compared with diabetics on metformin

 

1.22

(0.66-2.28)

for diabetics not on metformin, compared with diabetics on metformin

Currie et al. [44]

(2012)

UK, patients with solid tumors, including breast cancer stages I-IV

112,408

(25,575

breast cancer)

1,428 (1.3%)

metformin alone, 1,125 (1.0%)

metformin +

sulfonylurea 290

(0.3%) metformin + insulin

Mean 9.3,

median 6.8 (overall survival)

-

-

0.96e

(0.64-1.43)

  1. aAny recurrence; bdistant recurrence; cACEI or ARB use; dACEI only; ebreast cancer survivors only; see [44] for all cancer survivor numbers. CI, confidence interval; LACE, Life After Cancer Epidemiology; NS, not significant; RR, relative risk.