Review Article

Neuromuscular Blocking Agents and Cancer: A Narrative Review

Table 1

Summary of the main effects of NMBA on cancer.

AnaestheticsEffectsSummary

RocuroniumRocuronium bromide promotes the proliferation, migration, and invasion of breast cancer cell line MDA-MB-231. Rocuronium can promote the growth, invasion, and migration of gastric cancer cells SGC7901 and BGC823.Use with caution in patients with breast and stomach cancer
CisatracuriumCisatracurium enhances TRAIL-induced apoptosis in gastric cancer cells via p53 signaling. Cisatracurium inhibits proliferation, migration, and invasion of breast cancer MDA-MB-231 cells. Cisatracurium regulates the CXCR4/let-7a-5p axis by inhibiting the TGF-β/SMAD2/3 signaling pathway and inhibits colorectal cancer progression by altering the p53-dependent apoptotic pathway and delaying cell migration and invasion by upregulating p53, thereby inhibiting survival, metastasis, and tumor growth.It is recommended for patients with ovarian, breast, lung, rectal, and gastric cancers
AtracuriumAtracurium besylate promotes astrocyte differentiation and depletes glioblastoma stem cells. Atracurium gradually decreases the cell proliferation of hepatoma HepG2 cells in a concentration-dependent manner.Recommended for patients with glioblastoma and hepatocellular carcinoma
VecuroniumVecuronium bromide promotes adhesion of gastric cancer cells, inhibits proliferation and metastasis of non-small-cell lung cancer A549 cells, and has little effect on breast cancer cells.Can be used in breast cancer and non-small-cell lung cancer, but used with caution in gastric cancer
PancuroniumPatients with supratentorial tumors treated with pancuronium have significantly greater increases in intracranial pressure and cardiovascular parameters.Use with caution in patients with supratentorial tumors
PipecuroniumPipecuronium provides significantly greater cardiovascular stability and less elevation of intracranial pressure during and for the first 30 minutes after intubation.Suitable for use in patients with intracranial tumors
TubocurarineTubocurarine blocks the stimulating effect of pilocarpine on prostate cancer proliferation. Tubocurarine blocks acetylcholine- (ACh-) induced currents (IACh) in pheochromocytoma cells (PC12 cells).Suitable for use in patients with prostate cancer and pheochromocytoma

Note. The association of mivacurium, succinylcholine, gantacurium, and decamethonium bromide with tumor cell infiltration is unclear.