# Cancer neuroscience: cutting the nerve supply

Source: https://onco.cc/technologies/nerve-tumour-denervation/  
OnCo record `nerve-tumour-denervation` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tumours recruit nerves and use nerve signals to grow. Blocking that traffic, with beta-blockers or botulinum toxin, is being tested.

## Summary

Nerves infiltrate tumours and drive proliferation through adrenergic and cholinergic signalling; perineural invasion is a long-standing prognostic marker. Trials are testing perioperative propranolol in prostate cancer (NCT05679193, completed), pancreatic cancer (NCT06145074, recruiting), and beta-blockade with a COX-2 inhibitor in ovarian cancer (NCT06839144, recruiting). Botulinum toxin denervation has been trialled in gastric cancer. Effects so far are on biomarkers, not survival.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-08
- Tags: frontier; radical
- Principle: Adrenergic and cholinergic nerve endings supply growth and survival signals to tumour and stromal cells; pharmacological or surgical denervation removes them.
- Strengths: Uses cheap, long-established drugs; Targets the host, so tumour genotype does not matter; The perioperative window is a plausible high-impact moment
- Limitations: No survival benefit demonstrated; Small trials with biomarker endpoints; Beta-blockade has its own cardiovascular effects

## Sources

- Perioperative propranolol in PDAC (NCT06145074): https://clinicaltrials.gov/study/NCT06145074
- Beta-blockade in ovarian cancer (NCT06839144): https://clinicaltrials.gov/study/NCT06839144

## Connected records

- cancers: [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/), [Targeted Therapy](https://onco.cc/fronts/targeted-therapy/)
- technologies: [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/), [Exercise & lifestyle oncology](https://onco.cc/technologies/exercise-oncology/)
- terms: [Perineural invasion (PNI)](https://onco.cc/terms/perineural-invasion/)

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