Immunotherapy for Melanoma Could Be Made More Effective by Common Blood Pressure Drug

According to a new article published in the journal OncoImmunology, a class of drugs known as beta blockers, which are commonly prescribed to help lower blood pressure, could also improve survival time in patients with melanoma. The observational study found that patients taking beta blockers while receiving immunotherapy treatment for melanoma lived longer than those patients not taking the drug.

In animal experiments on mice, the researchers found the same result suggesting that ingestion of the beta blockers is related to improved survival time. Since beta blockers are inexpensive and widely available, the findings could help numerous patients improve their outcomes.

“The type of beta blocker we found to be effective against melanoma – pan beta blockers – was actually the least prescribed,” said Todd Schell, professor of microbiology and immunology at Penn State College of Medicine. “Most patients are either prescribed beta 1 selective blockers or are not taking beta blockers at all. This means there’s a large population of patients who may be eligible to take pan beta blockers while being treated with immunotherapy. And because beta blockers are already FDA approved, it’s something we know is safe and can be very quickly implemented in patient care.”

Immunotherapy can be a valuable treatment option for patients with metastatic melanoma, however it’s only effective in less than 35 percent of patients. Previous research suggests that higher levels of physiological stress impair the action of immunotherapy on the immune system, prompting Schell and his colleagues to wonder whether stress-reducing beta blockers might improve the efficacy of this cancer treatment.

“Beta blockers slow your heart rhythm, but they can also affect immune cells and improve immune function,” said Schell. “We wanted to see if there would be a correlation between the beta blockers patients were taking for another condition and their response to immunotherapy. For metastatic melanoma, there are currently three different types of immunotherapy approved for use, and we specifically looked at that population of people.”

In their study, the researchers analyzed data from nearly 200 patients with metastatic melanoma who were treated with immunotherapy between 2000 and 2015. Sixty-two of these patients were already taking beta blockers while undergoing cancer treatment.

The researchers compared survival of patients taking one-selective blockers or pan beta blockers to those patients not taking the blood pressure drugs. They found that patients taking the pan beta blockers lived significantly longer than the other patients, while those taking one-selective beta blockers or no beta blockers saw almost no difference in survival time.

The five-year survival for patients taking one-selective blockers or no blockers was around 25 percent, while 70 percent of patients taking pan beta blockers were still living at this time point. In mice models of melanoma treated with immunotherapy and the beta blocker drug propranolol, the researchers found reduced tumor growth and increased survival, mirroring the results of the observational study.

“These new immunotherapies are great, but they don’t work for everyone,” said Dr. Joseph Drabick, professor of medicine at Penn State. “So how can we make these treatments better? We saw that for patients taking pan beta blockers, there was a dramatic improvement in survival, and we were able to duplicate these findings in mice and see the exact same phenomenon.

“The benefit of this is that beta blockers already have a long history of safety in people, and they’re cheap and generic. And now they have the potential to augment some of these newer immunotherapy drugs to help people with cancer.”