β-Adrenergic Receptors : New Target in Breast Cancer

Abstract

Background: Preclinical studies have demonstrated that β-adrenergic receptor antagonists could improve the prognosis of breast cancer. However, the conclusions of clinical and pharmacoepidemiological studies have been inconsistent. This review was conducted to re-assess the relationship between beta-adrenoceptor blockers and breast cancer prognosis. Materials and Methods: The literature was searched from PubMed, EMBASE and Web of Nature (Thompson Reuters) databases through using key terms, such as breast cancer and betaadrenoceptor blockers. Results: Ten publications met the inclusion criteria. Six suggested that receiving betaadrenoceptor blockers reduced the risk of breast cancer-specific mortality, and three of them had statistical significance (hazard ratio (HR)=0.42; 95% CI=0.18-0.97; p=0.042). Two studies reported that risk of recurrence and distant metastasis (DM) were both significantly reduced. One study demonstrated that the risk of relapsefree survival (RFS) was raised significantly with beta-blockers (BBS) (HR= 0.30; 95% CI=0.10-0.87; p=0.027). One reported longer disease-free interval (Log Rank (LR)=6.658; p=0.011) in BBS users, but there was no significant association between overall survival (OS) and BBS (HR= 0.35; 95% CI=0.12-1.0; p=0.05) in five studies. Conclusions: Through careful consideration, it is suggested that beta-adrenoceptor blockers use may be associated with improved prognosis in breast cancer patients. Nevertheless, larger size studies are needed to further explore the relationship between beta-blocker drug use and breast cancer prognosis.

Anesthetic Considerations for Management of Cancer Patients to Decrease Cancer Recurrence

“…Similar findings were also reported in studies of hemangioma, neuroblastoma, melanoma and gastric cancer [49][50][51][52]. Chang et al go as far as to support the use of β-blockers as a possible novel therapeutic intervention, but that claim must be utilized with caution, as recent studies by Wang et al stated that B2 adrenergic stimulation with norepinephrine has actually attenuated invasion of certain types of breast CA's migration [53]. Thus despite overwhelming evidence that B-adrenergic stress responses is pro-cancerous, there is still need to quantify the exact types of cancers that are amenable to this type of therapy.…”

A new twist to neurotransmitter receptors and cancer

“…[28,29,64,[67][68][69][70][71] The potential usefulness of beta-blockers for adjuvant cancer treatment has additionally been discussed in depth based by comprehensive reviews of published preclinical and clinical literature. [67,72,73] By contrast, the current review analyzes mechanistic aspects of G s -coupled receptors and their physiological inhibitors and their modulating effects on cancer. The discrepancies between preclinical and clinical findings are thus not only triggered by the potential sensitization of β-ARs in response to long-term beta-blocker therapy (decades of treatment in people as opposed to a few weeks in experimental animals), but also by the potential impact of factors unrelated to β-ARs.…”

The molecular mechanism of chronic stress affecting the occurrence and development of breast cancer and potential drug therapy

“…The high expression of ΑDR-β in some breast cancer cell types affects the recurrence and metastasis of breast cancer, suggesting that blocking the ΑDR-β pathway is an effective strategy to slow down the progression of breast cancer [105] . A meta-analysis by Wang et al., a retrospective analysis by Zhao et al., a systematic analysis of cohort studies of breast cancer by Childers et al., and a clinical study analysis by Choy evaluated the relationship between ΑDR-β antagonists and breast cancer prognosis [32 , 33 , 149 , 165] . The results showed that BBS significantly reduced the risk of recurrence and distant metastasis, but most of these studies involved small samples and the follow-up time was relatively short; thus, larger studies are needed to further explore the relationship between BBS and breast cancer prognosis.…”