The success of the team of the Laboratory of Cancer Treatment and Tissue Regeneration

In November 2019, the paper „Incidental Use of Beta-Blockers Is Associated with Outcome of Metastatic Colorectal Cancer Patients Treated with Bevacizumab-Based Therapy: A Single-Institution Retrospective Analysis of 514 Patients“ was published in Cancers (Q1, IF2019: 6.162). This is an extensive retrospective study involving a total of 514 patients with metastatic colorectal cancer who were treated between 2005 and 2019 at the Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University. The work, led by Assoc. Prof. Ondřej Fiala, M.D., Ph.D., is based on the systematic cooperation of the Department of Oncology and Radiotherapy, the Department of Surgery and the Faculty of Medicine in Pilsen, Charles University. This collaboration is carried out under the auspices of the Laboratory of Tumor Treatment and Tissue Regeneration of the Medical Faculty’s Biomedical Center, which has long been involved in various clinical and experimental aspects of colorectal cancer and primary liver tumours.

Beta-adrenergic signalling plays an essential role in several processes that are important for the development and progression of various cancers. These processes include angiogenesis. The effect of the use of beta-blockers on the prognosis of cancer patients treated with anti-angiogenic agents is unclear and has been scarcely studied clinically. The aim of this study was to evaluate the association between the use of beta-blockers and the effect of treatment with a combination of chemotherapy and bevacizumab (a monoclonal antibody against vascular endothelial growth factor), which blocks angiogenesis. The association between progression-free survival (PFS) and overall survival (OS) with the use of beta-blockers and other common antihypertensive agents was evaluated. Of the commonly used antihypertensive agents, only beta-blockers had a significant impact on survival. The medians of PFS and OS in patients using beta-blockers prolonged to 11.4 and 26.8 months compared to the baseline values of 8.3 and 21.0 months in patients not using beta-blockers (p = 0.006 and p = 0.009, respectively). In the Cox multivariate model, the use of beta-blockers was a significant factor predicting both PFS (HR = 0.763, p = 0.021) and OS (HR = 0.730, p = 0.020). The results of this study show a significant association between the use of beta-blockers and the effect of treatment based on a combination of chemotherapy and bevacizumab. This is the first study of this kind conducted in a clinically relevant group of patients suggesting that beta-blockers might be the preferred type of antihypertensive in patients with metastatic colorectal cancer treated with this type of targeted therapy.

“From a clinical point of view, comedication is an extremely interesting topic in cancer patients. Although the results of this study are interesting, they need to be interpreted with caution, mainly because of its non-randomized retrospective design. We will stay focused on this topic with respect to other malignancies where anti-angiogenic targeted treatment is used,” adds doc. Fiala.

Vaclav Liska


Charles University
Faculty of Medicine in Pilsen
Biomedical Center

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