The impact of β-blockers on outcomes of immune checkpoint inhibitors therapy in advanced lung cancer: a multicenter real-world study

作者：Lingdan Chang, Haitian Zhang, Yunxia Li, Jilan Yang, Yitong Li, Guangming Wang, Jinsong Zhang, Hongjin Shi, Bing Hai · 发表于：Frontiers in Immunology · 年份：2025 · DOI：10.3389/fimmu.2025.1693249 · 被引用次数：3 · 研究领域：Cancer, Stress, Anesthesia, and Immune Response、Chemokine receptors and signaling、Nausea and vomiting management

Background: Immune checkpoint inhibitors (ICIs) have improved outcomes in advanced lung cancer. β-adrenergic signaling may promote tumor initiation and progression, and β-blockers (BBs) have emerged as anti-tumor sensitizing agents. This study evaluates the impact of BBs use during ICIs treatment in advanced lung cancer. Methods: This multicenter retrospective real-world study included 462 patients treated with ICIs from June 2019 to December 2024. Patients were divided into BBs and No BBs groups. Primary endpoints were overall survival (OS) and progression-free survival (PFS); efficacy evaluation and objective response rate (ORR) were secondary. Propensity score matching (PSM) balances baseline characteristics. Kaplan-Meier method, Cox, and logistic regression models were used for survival and multivariate analyses. Subgroup analyses assessed clinical factors. A P value < 0.05 is considered statistically significant. Results: After PSM, 318 patients were included (88 BBs, 230 No BBs). BBs use was associated with longer median PFS (mPFS) (15.8 vs. 11.8 months; HR = 0.67, 95% CI: 0.49-0.92, P = 0.038) and higher ORR (51.1% vs. 35.2%, P = 0.014), but not improved median OS (mOS) (29.0 vs. 31.5 months; HR = 1.38, 95% CI: 0.93-2.03, P = 0.108). BBs use independently predicted improved ORR (OR = 0.45, 95% CI: 0.26-0.78, P = 0.004) and longer PFS (HR = 0.67, 95% CI: 0.49-0.92, P = 0.014). In patients with cardiovascular comorbidities (CVD), BBs use was linked to longer mPFS (15.8 v...