Results from a retrospective, exploratory study of patients undergoing lung cancer resection who received either a beta-blocker or placebo during the perioperative period showed a trend toward improved postoperative relapse-free survival in the former group. The findings from this study were published in Scientific Reports.
There is evidence that chronic administration of oral beta-blockers in patients with cancer may improve prognosis, possibly through suppression of sequelae associated with release of epinephrine and norepinephrine. In this study, data from a previous prospective, randomized, controlled clinical trial of perioperative intravenous (IV) administration of low-dose landiolol or placebo performed to evaluate rates of postoperative atrial fibrillation in patients undergoing lung cancer resection were retrospectively analyzed to explore rates of relapse-free survival and overall survival (OS) in the 2 study arms.
Of the 57 patients included in the clinical trial, 28 and 29 were randomly assigned to the landiolol and placebo arms, respectively. The respective percentages of patients with different stages of disease in the 2 study arms (landiolol vs placebo) were as follows: stage IA (57.1% vs 48.3%; stage IB (10.7% vs 24.1%); stage IIA (17.9% vs 13.8%); stage IIB (3.6% vs 10.3%); stage IIIA (7.1% vs 3.4%) and stage IIIB (3.6% and 0.0%).
Although not statistically significant, a trend for improved postoperative relapse-free survival was observed for the patients treated with landiolol compared with placebo (hazard ratio [HR], 0.41; 95% CI, 0.13–1.34; log-rank test; P =.1294). The 2-year postoperative relapse-free survival rates were 0.89 (95% CI, 0.78–1.01) and 0.76 (95% CI, 0.60–0.91) for the landiolol and placebo arms, respectively. Although the study follow-up period was short, a trend toward improved OS was also observed for those in the landiolol arm compared with patients in the placebo arm (HR, 0.25; 95% CI, 0.03-2.26; log-rank test; P =.1836).
Because 6 patients had received adjuvant chemotherapy (4 in the landiolol arm and 2 in the placebo arm), a retrospective analysis was also performed that excluded these patients. Nevertheless, the same relapse-free survival trend in favor of the landiolol arm was observed in this subanalysis.
In their concluding remarks, the researchers wrote that “administering landiolol hydrochloride at low doses during cancer surgery for a short period of time tends to
improve relapse-free survival rate as well as prolong relapse-free survival and overall survival. This study was a retrospective, exploratory clinical study in a small sample size; it would be beneficial if large-scale, prospective clinical studies are conducted in the future.”
- Sakamoto A, Yagi K, Okamura T, et al. Perioperative administration of an intravenous beta-blocker landiolol hydrochloride in patients with lung cancer: A Japanese retrospective exploratory clinical study. Sci Rep. 2019;9:5217. doi: 10.1038/s41598-019-41520-7