Cut the nerve supply to tumours with old drugs

This idea proposes cutting the nerve supply to tumours with old drugs: nerves feed pancreatic, prostate and other tumours, and beta-blockers and botulinum toxin are cheap, safe and in trials. Propranolol reduced proliferation markers in window trials, denervation slowed gastric cancer in mice, perampanel targets glioma synapses, and perineural invasion is strongly prognostic. The hypothesis, rooted in the Cancer neuroscience pathway, is that beta-blockade or denervation added to standard therapy improves outcomes in tumours with high perineural invasion or an adrenergic signature. The tests are a randomised phase 2 of propranolol in resectable Pancreatic ductal adenocarcinoma and a perampanel trial in Glioma & glioblastoma; Prostate cancer is also in scope.