Trial watch: beta-blockers in cancer therapy

Abstract

Compelling evidence supports the hypothesis that stress negatively impacts cancer development and prognosis. Irrespective of its physical, biological or psychological source, stress triggers a physiological response that is mediated by the hypothalamic-pituitary-adrenal axis and the sympathetic adrenal medullary axis. The resulting release of glucocorticoids and catecholamines into the systemic circulation leads to neuroendocrine and metabolic adaptations that can affect immune homeostasis and immunosurveillance, thus impairing the detection and eradication of malignant cells. Moreover, catecholamines directly act on β-adrenoreceptors present on tumor cells, thereby stimulating survival, proliferation, and migration of nascent neoplasms. Numerous preclinical studies have shown that blocking adrenergic receptors slows tumor growth, suggesting potential clinical benefits of using β-blockers in cancer therapy. Much of these positive effects of β-blockade are mediated by improved immunosurveillance. The present trial watch summarizes current knowledge from preclinical and clinical studies investigating the anticancer effects of β-blockers either as standalone agents or in combination with conventional antineoplastic treatments or immunotherapy.

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review

“…The clinical trial by Cui et al reported that low plasma level of epinephrine was significantly correlated with better recurrence-free and overall survival in breast cancer patients [62]. In line with this, data extracted from retrospective studies in which some patients incidentally received betablockers revealed better outcomes after cancer surgery [64]. A few prospective studies also supported that beta-blockers reduced the incidence of recurrence and the risk of progressive disease [65,66].…”