Re: Carvedilol blocks neural regulation of breast cancer progression in vivo and is associated with reduced breast cancer mortality in patients

With great interest, we read the paper by Gillis et al. [ [1] Gillis R.D. Botteri E. Chang A. Ziegler A.I. Chung N.C. Pon C.K. et al. Carvedilol blocks neural regulation of breast cancer progression in vivo and is associated with reduced breast cancer mortality in patients. Eur J Canc. 2021 Feb 24; 147: 106-116 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ] on β-adrenergic receptor antagonists (or β-blockers) activity on breast cancer (BC). Starting from the available evidence of a favouring role of the sympathetic – rather than the parasympathetic – nervous system on BC progression, the authors studied carvedilol treatment in preclinical models of BC (both cell lines and mice), thus showing that the inhibition of the sympathetic nervous system activity corresponds to a slowing of cancer progression. Besides bench models, they analysed a wide retrospective registry-based cohort of patients with localised BC to compare the clinical effect of carvedilol in respect to other anti-hypertensive treatments on BC-specific mortality, finding a significant reduction of the outcome measures in carvedilol users. Carvedilol blocks neural regulation of breast cancer progression in vivo and is associated with reduced breast cancer mortality in patientsEuropean Journal of CancerVol. 147PreviewThe sympathetic nervous system drives breast cancer progression through β-adrenergic receptor signalling. This discovery has led to the consideration of cardiac β-blocker drugs as novel strategies for anticancer therapies. Carvedilol is a β-blocker used in the management of cardiovascular disorders, anxiety, migraine and chemotherapy-induced cardiotoxicity. However, little is known about how carvedilol affects cancer-related outcomes. Full-Text PDF Response to the letter Re: Carvedilol blocks neural regulation of breast cancer progression in vivo and is associated with reduced breast cancer mortality in patientsEuropean Journal of CancerVol. 152PreviewWe thank De Sanctis et al. for their interest in the findings reported in ‘Carvedilol blocks neural regulation of breast cancer progression in vivo and is associated with reduced breast cancer mortality in patients’ [1]. They raise the interesting suggestion that other conditions linked to elevated sympathetic nervous system (SNS) activity, such as pain and migraine, may influence cancer progression. De Sanctis et al's. comments about migraine are especially interesting given that beta-blockers are commonly taken long term and as a prophylactic treatment to reduce the frequency of migraines. Full-Text PDF