Beta-blockers exert potent anti-tumor effects in cutaneous and uveal melanoma

Cancer Med. 2019 Dec;8(17):7265-7277. doi: 10.1002/cam4.2594. Epub 2019 Oct 7.


Background: Melanoma is a life-threatening group of cancers mainly affecting the skin (cutaneous melanoma, CM) and the eyes (uveal melanoma, UM). Nearly half of patients with UM develop liver metastases regardless of the primary treatment. For this reason, adjuvant therapy to prevent disease progression is essential to improve survival of patients with melanoma. Beta-adrenoceptors (β-AR) have emerged as novel targets to inhibit tumor growth and dissemination in CM, but have not been investigated in UM.

Methods: The aim of this study was to comprehensively evaluate the effects of a non-selective β-blocker in UM and CM. Propranolol was tested on four UM and two CM cell lines to determine the effects of this beta-blocker. The expression of β-AR in UM was assessed in enucleated eyes of 36 patients.

Results: The results showed that propranolol exerts potent anti-proliferative effects, attenuates migration, reduces VEGF and induces cell cycle arrest and apoptosis in both UM and CM in a dose-dependent manner. Furthermore, levels of cell-free DNA released from the cells correlated to propranolol treatment and may be an indicator of treatment response. Finally, immunohistochemical analysis revealed the expression of β1 and β2 adrenoceptors in all UM patients, with higher expression seen in the more aggressive epithelioid versus less aggressive spindle cells.

Conclusions: Collectively our data suggest that a nonselective beta-blocker may be effective against melanoma. For the first time, we show potent anti-tumor effects in UM cells following propranolol administration and expression of β1 and β2 adrenoceptors in patient tissue.

Keywords: adjuvant therapy; beta-blockers; melanoma; uveal melanoma.

MeSH terms

  • Adrenergic beta-Antagonists / pharmacology*
  • Adrenergic beta-Antagonists / therapeutic use
  • Apoptosis / drug effects
  • Cell Line, Tumor
  • Cell Movement / drug effects
  • Cell Proliferation / drug effects
  • Drug Screening Assays, Antitumor
  • Humans
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Melanoma / surgery
  • Primary Cell Culture
  • Propranolol / pharmacology*
  • Propranolol / therapeutic use
  • Receptors, Adrenergic, beta-1 / analysis
  • Receptors, Adrenergic, beta-1 / metabolism
  • Receptors, Adrenergic, beta-2 / analysis
  • Receptors, Adrenergic, beta-2 / metabolism
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Uvea / pathology
  • Uvea / surgery
  • Uveal Neoplasms / drug therapy*
  • Uveal Neoplasms / pathology
  • Uveal Neoplasms / surgery


  • ADRB1 protein, human
  • ADRB2 protein, human
  • Adrenergic beta-Antagonists
  • Receptors, Adrenergic, beta-1
  • Receptors, Adrenergic, beta-2
  • Propranolol

Supplementary concepts

  • Uveal melanoma