Beta-blockers improve lung cancer survival after radiotherapy
Persons with non-small cell lung cancer (NSCLC) who received definitive radiotherapy survived longer than did similar patients if beta-blockers were added to the mix.
In a retrospective review of 722 patients with NSCLC, 155 subjects were found to have been using beta-blockers to combat hypertension, heart disease, or other conditions. All patients underwent definitive radiotherapy—that is, radiotherapy delivered at doses of 60 Gy or more, with the intention of curing the disease.
The group taking beta-blockers survived for an average of 23.7 months, compared to the average 18.6 months recorded among the other 567 patients. This translated to a 22% improvement in survival after adjusting for age, disease stage, concurrent chemotherapy, presence of chronic obstructive pulmonary disease, aspirin use, and other factors.
Beta-blocker intake also was associated with significantly better distant-metastasis-free survival and disease-free survival, but not with better locoregional-progression-free survival.
As noted by investigator Daniel Gomez, MD, a radiation oncologist at The University of Texas MD Anderson Cancer Center in Houston, metastasis is a major reason for the low 5-year survival rate (less than 15%) among persons with NSCLC. “Therefore, we urgently need to find new ways of blocking the development of metastases in these patients,” he commented in a statement issued by the European Society for Medical Oncology (ESMO). Gomez's group's findings were published in Annals of Oncology, the official journal of ESMO.
Preclinical studies have shown that norepinephrine can directly stimulate tumor cell migration to other parts of the body, and that the beta-adrenergic receptors on cell surfaces are involved in this process. Beta-blockers inhibit those receptors.
Gomez said that to his team's knowledge, this is the first analysis to show a survival benefit associated with the use of beta-blockers during definitive radiotherapy in patients with NSCLC. However, prospective studies are needed to further explore these results.