Cancer neuroscience: cutting the nerve supply
Tumours recruit nerves and use nerve signals to grow. Blocking that traffic, with beta-blockers or botulinum toxin, is being tested.
Nerves infiltrate tumours and drive proliferation through adrenergic and cholinergic signalling; perineural invasion is a long-standing prognostic marker. Trials are testing perioperative propranolol in prostate cancer (NCT05679193, completed), pancreatic cancer (NCT06145074, recruiting), and beta-blockade with a COX-2 inhibitor in ovarian cancer (NCT06839144, recruiting). Botulinum toxin denervation has been trialled in gastric cancer. Effects so far are on biomarkers, not survival.
How it works
Adrenergic and cholinergic nerve endings supply growth and survival signals to tumour and stromal cells; pharmacological or surgical denervation removes them.
- Uses cheap, long-established drugs
- Targets the host, so tumour genotype does not matter
- The perioperative window is a plausible high-impact moment
- No survival benefit demonstrated
- Small trials with biomarker endpoints
- Beta-blockade has its own cardiovascular effects
Latest papers
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