Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
Clin Lung Cancer. 2021 Jan;22(1):e57-e62. doi: 10.1016/j.cllc.2020.07.016. Epub 2020 Aug 5.
Beta blockers have been associated with anti-tumorigenic effects, potentially by reducing adrenergic-mediated stress responses. Preclinical studies have additionally shown that beta blockade may enhance the efficacy of cancer immunotherapy. We investigated patients with lung cancer who concomitantly used beta blockers and immune checkpoint inhibitors (ICIs), with the hypothesis that beta blockade would positively impact clinical outcomes.
We retrospectively reviewed the health records of 109 patients who were treated at Northwestern University from January 2014 through August 2018 with ICIs for non-small-cell lung cancer (NSCLC). Comparisons of overall survival and progression-free survival (PFS) were performed using Kaplan-Meier analysis with log-rank test, and a univariate regression analysis was performed with a Cox proportional hazards model.
Among 109 patients treated with ICIs for NSCLC, 28 of them were concomitantly prescribed beta blockers. Use of beta blockers was associated with increased PFS, with a hazard ratio of 0.58 and 95% confidence interval of 0.36 to 0.93. There was not a significant increase in overall survival among patients who took beta blockers (hazard ratio, 0.66; 95% confidence interval, 0.38-1.17). In a regression model, beta blockers were identified as predictive of PFS, as were non-squamous histology, tumor programmed death-ligand 1 positivity, and lower line of treatment.
Our data suggests beta blocker use may be associated with improved PFS among patients treated with ICIs for NSCLC. This was a small study, and these findings should be further validated in prospective clinical studies.
β受体阻滞剂与抗肿瘤作用有关，可能是通过减少肾上腺素能介导的应激反应。临床前研究还表明，β受体阻滞剂可能增强癌症免疫治疗的疗效。我们研究了同时使用β受体阻滞剂和免疫检查点抑制剂（ICI）的肺癌患者，假设β受体阻滞剂会对临床结果产生积极影响。
我们回顾性分析了 2014 年 1 月至 2018 年 8 月在西北大学接受 ICI 治疗非小细胞肺癌（NSCLC）的 109 例患者的健康记录。使用 Kaplan-Meier 分析和对数秩检验比较总生存期和无进展生存期（PFS），并使用 Cox 比例风险模型进行单变量回归分析。
在 109 例接受 ICI 治疗的 NSCLC 患者中，有 28 例同时开具了β受体阻滞剂。β受体阻滞剂的使用与 PFS 增加相关，风险比为 0.58，95%置信区间为 0.36 至 0.93。β受体阻滞剂组患者的总生存期无显著增加（风险比，0.66；95%置信区间，0.38-1.17）。在回归模型中，β受体阻滞剂是 PFS 的预测因素，非鳞状组织学、肿瘤程序性死亡配体 1 阳性和治疗线较低也是 PFS 的预测因素。
我们的数据表明，β受体阻滞剂的使用可能与接受 ICI 治疗的 NSCLC 患者的 PFS 改善有关。这是一项小型研究，这些发现应在前瞻性临床研究中进一步验证。
