1Department of MLT & Biochemistry, School of Allied Health Sciences, SGT University, Gurugram 122505, Haryana, India
Propranolol Hydrochloride, a non-selective β-adrenergic receptor antagonist originally developed for cardiovascular disorders, has attracted growing interest as a repurposed therapeutic candidate in oncology. Increasing experimental and translational evidence indicates that β-adrenergic signaling plays a pivotal role in tumor progression by linking chronic sympathetic nervous system activation to molecular pathways governing proliferation, angiogenesis, immune evasion, invasion, and metastatic spread. By competitively inhibiting β1- and β2-adrenergic receptors, propranolol interferes with catecholamine-mediated cAMP–PKA and EPAC signaling cascades, thereby modulating transcriptional programs associated with VEGF expression, matrix metalloproteinase activation, inflammatory cytokine production, epithelial–mesenchymal transition, and stress-induced immune suppression. Preclinical investigations across multiple tumor models demonstrate that propranolol can attenuate tumor growth, suppress angiogenesis, reduce metastatic colonization, and enhance anti-tumor immune responses. Importantly, its anti-cancer activity appears most pronounced in stress-responsive and highly vascular tumors, and in the perioperative setting where adrenergic surges may facilitate micrometastatic dissemination. Propranolol has also shown synergistic interactions with conventional chemotherapeutics, targeted agents, radiotherapy, and immune checkpoint blockade, supporting its development primarily as a co-adjuvant rather than a standalone cytotoxic therapy. The extensive clinical experience, affordability, and mechanistic plausibility of Propranolol Hydrochloride represents a compelling candidature for oncologic repurposing. Future directions should integrate biomarker-guided trial designs, combination regimens, advanced tumor-targeted delivery systems, and systems-biology or artificial intelligence-based repurposing pipelines to refine therapeutic positioning. Collectively, current mechanistic, preclinical, and emerging clinical data justify rigorous evaluation of Propranolol as a multi-pathway modulator in contemporary cancer therapy.
Keywords: Propranolol Hydrochloride, Cancer, Drug repurposing, β-Blocker.
How to cite this article: Kumari D, Tiwari BK. Propranolol Hydrochloride as a Repurposed β-Blocker in Cancer Therapy: Mechanisms, Evidence, and Clinical Perspectives. Int J Drug Deliv Technol. 2026;16(15s): 413-431. DOI: 10.25258/ijddt.16.15s.50
Source of support: Nil.
Conflict of interest: None