Real-world Association Between Concomitant Beta-blocker Exposure and Anti-PD-1/PD-L1 Treatment Outcomes in Advanced Non-Small Cell Lung Cancer

Background:

Emerging evidence suggests that beta-adrenergic signaling may contribute to T-cell dysfunction and resistance to immune checkpoint blockade. This retrospective real-world cohort study was designed to investigate whether concomitant long-term beta-blocker exposure during routine clinical care was associated with treatment outcomes in patients with advanced NSCLC receiving standard anti-PD-1/PD-L1 inhibitor therapy.

Study Design:

Clinical data and follow-up information were collected retrospectively from eligible patients treated in routine clinical practice at the Affiliated Hospital of Nantong University during the predefined study period. Patients were categorized into exposure cohorts according to whether they had documented concomitant long-term beta-blocker use during anti-PD-1/PD-L1 treatment. The study did not assign treatment or medication exposure; all therapies and concomitant medications were prescribed according to standard clinical indications and physician judgment.

Objectives:

The primary objective was to assess the association between concomitant long-term beta-blocker exposure and progression-free survival. Secondary objectives included evaluation of objective response rate and overall survival. The study was intended to provide real-world observational evidence regarding the clinical relevance of beta-blocker exposure in the setting of standard anti-PD-1/PD-L1 therapy for advanced NSCLC.

Inclusion criteria

• Age 18 years or older;
• Histologically or cytologically confirmed advanced or metastatic non-small cell lung cancer;
• Received standard anti-PD-1/PD-L1 inhibitor therapy during routine clinical care;
• Available baseline clinical records and follow-up data sufficient for assessment of treatment exposure and clinical outcomes;

Exclusion criteria

• Incomplete baseline clinical records or follow-up data that preclude assessment of treatment exposure or clinical outcomes;
• Concomitant participation in an interventional therapeutic clinical trial affecting the same treatment course, if applicable;
• Other major clinical conditions or competing malignancies that preclude valid outcome assessment, according to the prespecified study protocol