Research paper: Lung cancerEffect of beta-blockers on survival of lung cancer patients: a systematic review and meta-analysisCoelho, Marisaa,,b,,c; Squizzato, Alessandrod; Cassina, Niccolòc; Marino, Francac; Ribeiro, Laura Virgíniaa,,b; Cosentino, MarcocAuthor Information aDepartment of Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto bI3S–Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal cCenter of Research in Medical Pharmacology, University of Insubria dResearch Center on Thromboembolic Disorders and Antithrombotic Therapies, Department of Medicine and Surgery, University of Insubria, Varese, Italy Received 14 July 2019 Accepted 1 August 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.eurjcancerprev.com). Correspondence to Marisa Coelho, PhD, Unit of Biochemistry, Faculty of Medicine, Department of Biomedicine, University of Porto, 4200-450 Porto, Portugal, Tel: +351 22042665; fax: +39 0332 219039; e-mail: email@example.com European Journal of Cancer Prevention: July 2020 - Volume 29 - Issue 4 - p 306-314 doi: 10.1097/CEJ.0000000000000544 Buy SDC Metrics Abstract The recent interest in beta-blockers as possible agents for drug repurposing in oncology arises from many pre-clinical and epidemiologic studies suggesting a possible clinically relevant antitumour effect. In lung cancer, given the contradictory results obtained, it is crucial to further study its effects. A systematic review of the literature was planned to evaluate a possible beneficial effect of beta-blocker on overall survival in lung cancer patients. Medline and Embase databases were searched from inception until 1 May 2018 to identify published studies that assessed the effect beta-blocker use on overall survival in lung cancer patients. Risk of bias was evaluated by Newcastle-Ottawa scale. Hazard ratios and 95% confidence intervals for overall survival were estimated using a random-effects model. Of 920 studies, seven (all retrospective and observational, six cohort and one case-control), including 7448 patients, met the inclusion criteria. Beta-blocker users with lung cancer had no increased overall survival compared to non-users (hazard ratio = 1.00; 95% confidence interval = 0.91–1.10; I2 = 45%). Similarly, beta-blocker users with non-small cell lung cancer had no increased overall survival compared to beta-blocker non-users (hazard ratio = 0.96; 95% confidence interval = 0.80–1.17; I2 = 56%). Our findings do not suggest an overall survival advantage in patients with lung cancer using beta-blocker therapy when compared to non-users. Further prospective cohort studies, designed to overcome the intrinsic limitations of retrospective observational studies are warranted to definitively clarify any possible beneficial effect of beta-blockers on lung cancer overall survival. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.