An old new friend
Researchers at Penn State University found that patients with melanoma receiving immunotherapy and taking non-selective beta-blockers according to indications (arterial hypertension, cardiovascular insufficiency, arrhythmias) live longer compared to patients receiving only immunotherapy treatment. In a study on mice, the same results were obtained.
Todd Schell, one of the authors of the article and the head of the study, notes that beta-blockers could be a good way to increase the clinical effectiveness of melanoma immunotherapy, because they have been studied and available for a long time.
The study is about non-selective beta blockers – a group of drugs that block both types of beta-adrenergic receptors (beta-1 and beta-2). Most often, selective beta blockers are prescribed for the treatment of cardiovascular diseases, since they have fewer side effects. The authors believe that in the treatment of melanoma with immunotherapeutic agents, such patients can be recommended to change treatment with selective beta-blockers to non-selective ones. This will help to strengthen the effectiveness of melanoma treatment and continue the treatment of concomitant cardiovascular diseases. Since this group of drugs has been studied and approved for use, the introduction of a new method should not take much time.
In metastatic melanoma, that is, when the tumor spreads beyond the primary focus, the prognosis of the disease is considered poor. Immunotherapy, which is quite effective for cancer of another localization, is not effective enough in this case – less than 35% of patients respond positively to treatment.
In previous studies, it has been proven that physiological stress prevents the immune system from fighting the tumor, while reducing stress levels increases the effectiveness of this fight. The researchers were interested in whether beta-blockers could reduce stress and improve outcomes in patients receiving immunotherapy treatment for melanoma by reducing heart rate.
Three types of immunotherapy are currently approved for the treatment of metastatic melanoma. The researchers evaluated the effectiveness of combining beta blockers with each of them.
The study involved 195 patients with metastatic melanoma who underwent immunotherapy from 2000 to 2005. 62 patients received non-selective or selective beta-blockers in addition to the main treatment. Their data were retrospectively analyzed and statistically processed. Survival was assessed in three groups of patients: those receiving isolated immunotherapy, those receiving immunotherapy in combination with selective beta-blockers and those receiving immunotherapy in combination with non-selective beta-blockers.
Taking selective beta blockers did not improve survival compared to patients who took nothing but drugs as part of immunotherapy. Patients taking nonselective beta blockers had a higher survival rate: after five years, it was 70%, while in the other two groups it was 25%.
In order to understand the results of the study, the authors conducted an experiment on mouse models. The mice received immunotherapy in combination with or without the non-selective beta-blocker propranolol. It was found that in the propranolol group, tumor growth significantly slowed down, and survival was higher.
Thus, the results confirmed the hypothesis that reducing stress by slowing the heart rate with beta-blockers increases the effectiveness of melanoma immunotherapy and improves survival.
The advantages of beta blockers are that they have been studied for a long time, are safe, cheap and widespread.
The authors intend to organize and conduct larger studies to further study and understand the role of beta blockers in cancer treatment.
Article by Kathleen M. Kokolus et al. Beta blocker use correlates with better overall survival in metastatic melanoma patients and improves the efficacy of immunotherapies in mice published in the journal OncoImmunology.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru based on the materials of PennState Health News: Beta blockers may boost immunotherapy, help melanoma patients live longer.