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Beta blockers are being studied as possible additions to cancer treatment, particularly propranolol around surgery, but they are not established cancer therapies. Evidence so far does not show that they reliably prevent recurrence or extend survival. A beta blocker prescribed during cancer care for a separate heart-related reason is not being used to treat the tumor.
What does the evidence say about beta blockers and cancer?
The evidence is promising enough to investigate, but not strong enough to support beta blockers as cancer treatment. Studies differ in cancer type, treatment timing, the beta blocker used, and the outcomes measured. A biological change in a tumor or a biomarker is not the same as evidence that patients live longer or are less likely to have cancer return.
Propranolol around surgery
A 2025 systematic review searched five databases through July 1, 2024, and included 31 studies: 7 randomized controlled trials, 4 systematic reviews, and 20 meta-analyses. It described a possible signal of benefit, particularly for perioperative propranolol—use around the time of surgery. That signal supports further study; it does not establish fewer recurrences or longer survival.
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A randomized, placebo-controlled phase II breast cancer study reported changes in biomarkers associated with metastatic potential after preoperative propranolol. These were biological endpoints, not proof of fewer metastases, recurrences, or deaths. The study authors called for larger phase III trials designed to measure recurrence and survival.
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Use with chemotherapy or radiotherapy
The 2025 propranolol review found results inconclusive for combinations with chemotherapy or radiotherapy. Timing may matter, but the available evidence does not establish an effective drug regimen or identify which patients, if any, benefit.
Do beta blockers improve outcomes with immunotherapy?
A 2025 systematic review and meta-analysis examined beta blockers used with immune checkpoint inhibitors in solid tumors. It included 12 clinical studies and 4,293 patients. The pooled results did not show longer overall survival or progression-free survival:
| Outcome | Pooled estimate | What it indicates |
|---|---|---|
| Overall survival | HR 1.02; 95% CI 0.84–1.23 | No pooled survival advantage was demonstrated. |
| Progression-free survival | HR 0.98; 95% CI 0.80–1.20 | No pooled advantage in time before progression or death was demonstrated. |
These pooled findings do not prove that every beta blocker has no effect in every cancer setting. They do mean that current evidence does not support describing beta blockers combined with immune checkpoint inhibitors as a proven way to extend survival. The review reported no apparent increase in toxicity from the combination; prospective trials are still awaited.
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Beta blockers can be considered for cardiovascular reasons, which is a separate question from whether they treat cancer. A 2024 JACC: CardioOncology expert panel recommends considering ACE inhibitors, angiotensin receptor blockers (ARBs), and/or beta blockers to help prevent a decline in left ventricular ejection fraction (LVEF) for some patients with breast cancer receiving HER2-targeted therapy. LVEF is a measure of how much blood the heart’s main pumping chamber ejects with each beat.
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The panel says it remains unclear whether these medicines prevent heart failure. It cited a review of 9 randomized trials involving 1,362 participants in which pooled mean LVEF was 2.3 percentage points higher with ACE inhibitors, ARBs, or beta blockers than with control (95% CI 0.0–4.6). Because the analysis combined different drug classes, and the clinical benefit remains unclear, this figure should not be read as evidence that beta blockers alone prevent heart failure—or that they have an anticancer effect.
What cancer trials are studying beta blockers?
The National Cancer Institute’s beta-adrenergic antagonist trial index listed 15 trials when accessed in October 2026. Examples marked active on that indexed page included studies of propranolol for Kaposi sarcoma; propranolol with pembrolizumab and chemotherapy for PD-L1-positive advanced or metastatic triple-negative breast cancer; and propranolol with pembrolizumab and chemotherapy for advanced esophageal or gastroesophageal-junction adenocarcinoma.
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Other examples included propranolol with chemoradiation for esophageal cancer, and naltrexone plus propranolol with standard immunotherapy for stage II–III melanoma. Trial status and locations can change, so check the NCI listing for current details. A study being listed as active means the question is under investigation, not that benefit has been proven or that the regimen is a treatment recommendation.
How to judge claims about beta blockers and cancer
When evaluating a study or headline, check what was actually tested and measured. In particular, distinguish:
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- The cancer and its stage: A result in one cancer or stage cannot automatically be applied to another.
- The specific drug and timing: Propranolol and other beta blockers are not interchangeable evidence, and perioperative use may differ from use alongside chemotherapy, radiotherapy, or immunotherapy.
- The comparison group: A randomized trial assigning treatment answers a different question from an observational study of people already taking a beta blocker for a cardiovascular reason.
- The endpoint: A biomarker change, tumor response, recurrence, progression-free survival, and overall survival are distinct outcomes. Improvement in one does not establish improvement in the others.
Should you start, stop, or change a beta blocker?
No. Do not start, stop, or change propranolol or another beta blocker to try to affect cancer outcomes. Drug selection, dose, interactions, contraindications, and any heart monitoring need to be assessed by the treating clinician. If you already take one, discuss its purpose and any concerns with your oncology or cardiovascular care team rather than changing it on your own.
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