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Review
. 2025 Apr 18;17(8):1357.
doi: 10.3390/cancers17081357.

The Impact of Beta Blockers on Survival in Cancer Patients: A Systematic Review and Meta-Analysis

Alisha E Sharma  1 , Stephanie Chan  2 , Adam S Komorowski  3 , Xingshan Cao  4 , Yizhuo Gao  5 , Kushal Kshatri  6 , Kairavi Desai  7 , Markus Kuksis  8 , Michael Rosen  9 , Anjali Sachdeva  10 , Isabella Kojundzic  11 , Saif Samari  6 , Iacovos P Michael  12 , Husam Abdel-Qadir  13 , Katarzyna J Jerzak  13   14
Affiliations
Review

The Impact of Beta Blockers on Survival in Cancer Patients: A Systematic Review and Meta-Analysis

Alisha E Sharma et al. Cancers (Basel). .

Abstract

Background/objectives: Beta adrenergic signaling has been implicated in cancer progression, leading to interest in repurposing beta blockers (BBs) as adjunctive anti-cancer agents. However, clinical findings are inconsistent. This systematic review and meta-analysis evaluates the association between BB use and survival outcomes in cancer patients.

Methods: A systematic search of OVID Medline, EMBASE, and CENTRAL was conducted through 13 September 2023, for studies comparing survival outcomes in solid tumor patients using BBs versus non-users. Eligible studies reported hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS), or cancer-specific survival (CSS). Perioperative studies and those without BB-specific HRs were excluded. Data extraction and quality assessment were performed in duplicate using ROBINS-I. A random-effects model was used, with heterogeneity assessed by the I2 statistic.

Results: Seventy-nine studies (492,381 patients) met the inclusion criteria; 2.5% were prospective. The most frequently studied cancers were breast (n = 33), ovarian (n = 30), and colorectal (n = 28). BB use was associated with improved PFS (HR 0.78, 95% CI: 0.66-0.92, I2 = 79.8%), with significance maintained after excluding high-bias studies (HR 0.74, 95% CI: 0.61-0.91, I2 = 36.6%). No significant associations were observed for OS (HR 0.99, 95% CI: 0.94-1.04, I2 = 84.9%) or CSS (HR 0.95, 95% CI: 0.91-1.00, I2 = 77.4%).

Conclusions: BB use may be associated with longer PFS in cancer patients, but findings are limited by study design and heterogeneity; high-quality prospective studies are needed.

Keywords: beta blockers; cardio-oncology; drug repurposing; pharmacology.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Beta adrenergic receptor signaling pathway. Legend: ATP, adenosine triphosphate; cAMP, cyclic adenosine monophosphate; PDE, phosphodiesterase; PKA, protein kinase A; Gαs, G-alpha subunit; Gβ/γ, G-beta/gamma subunits; β1, β2, β3, beta-adrenergic receptors.
Figure 2
Figure 2
PRISMA diagram [12].
Figure 3
Figure 3
Progression-free survival among cancer patients who were beta blocker users versus non-users.
Figure 4
Figure 4
Cancer-specific survival among cancer patients who were beta blocker users versus non-users.
Figure 5
Figure 5
Overall survival among cancer patients who were beta blocker users versus non-users.
Figure 6
Figure 6
Progression-free survival subgroup by cancer type.
Figure 7
Figure 7
Progression-free survival sensitivity analysis for immortal time bias.
See this image and copyright information in PMC

References

    1. Qiao G., Chen M., Bucsek M., Repasky E., Hylander B. Adrenergic Signaling: A Targetable Checkpoint Limiting Development of the Antitumor Immune Response. Front. Immunol. 2018;9:164. doi: 10.3389/fimmu.2018.00164. - DOI - PMC - PubMed
    1. Chang A., Botteri E., Gillis R., Löfling L., Le C., Ziegler A., Chung N., Rowe M., Fabb S., Hartley B., et al. Beta-Blockade Enhances Anthracycline Control of Metastasis in Triple-Negative Breast Cancer. Sci. Transl. Med. 2023;15:eadf1147. doi: 10.1126/scitranslmed.adf1147. - DOI - PubMed
    1. Nissen M.D., Sloan E.K. β-Adrenergic Signaling Impairs Antitumor CD8+ T-Cell Responses to B-Cell Lymphoma Immunotherapy. Cancer Immunol. Res. 2018;6:98–109. doi: 10.1158/2326-6066.CIR-17-0401. - DOI - PubMed
    1. Sloan E.K., Priceman S.J., Cox B., Yu S., Pimentel M., Tangkanangnukul V., Arevalo J., Morizono K., Karanikolas B., Wu L., et al. The Sympathetic Nervous System Induces a Metastatic Switch in Primary Breast Cancer. Cancer Res. 2010;70:7042–7052. doi: 10.1158/0008-5472.CAN-10-0522. - DOI - PMC - PubMed
    1. Chang A., Le C.P., Walker A., Creed S., Pon C., Albold S., Carroll D., Halls M., Lane J.R., Riedel B., et al. β2-Adrenoceptors on Tumor Cells Play a Critical Role in Stress-Enhanced Metastasis in a Mouse Model of Breast Cancer. Brain Behav. Immun. 2016;57:106–115. doi: 10.1016/j.bbi.2016.06.011. - DOI - PMC - PubMed

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