Los Angeles: Regular use of a common type of medications, such as aspirin and ibuprofen, may significantly improve survival for patients with head and neck cancer, a study has found.
Non-steroidal anti-inflammatory drugs (NSAIDs) improved the overall five-year survival rate from 25% to 78% for patients whose cancer contained a specific altered gene, known as PIK3CA, according to researchers from the University of California, San Francisco (UCSF) in the US.
The survival for patients whose gene was not altered in their tumour was unaffected by NSAID use.
This is the first study to show a strong clinical advantage of regular NSAID use for head and neck cancer patients with mutations in the PIK3CA gene and may indicate a clear, biological reason to implement NSAID therapy in certain cases of the disease, researchers said.
“Our results suggest that the use of NSAIDs could significantly improve outcomes for not only head and neck cancer patients, but also patients with other cancers that contained the PIK3CA mutation,” said Jennifer R Grandis, a professor at UCSF.
“The magnitude of the apparent advantage is strong, and could potentially have a positive impact on human health,” Grandis said, senior author of the study published in the Journal of Experimental Medicine.
Within head and neck squamous cell carcinoma, PIK3CA is the most commonly altered oncogene, with 34% of all tumours carrying mutations that activate the PIK3CA gene.
In head and neck cancer associated with the human papillomavirus (HPV), PIK3CA is mutated in more than half of tumours.
Head and neck squamous cell carcinoma is a complex malignancy that carries a poor prognosis: the five-year survival rate is about 45%.
Why ibuprofen or aspirin
NSAIDs, which include over-the-counter drugs such as ibuprofen and aspirin, are known to relieve pain and reduce inflammation, fever and blood clots. They are the most frequently prescribed medication for conditions such as arthritis.
The easy availability of ibuprofen and aspirin should make medication for cancer a less daunting task.
In the new research, 266 patients whose tumours were surgically removed were investigated by researchers. The majority (84%) smoked and 67% received post-surgery chemotherapy and/or radiotherapy. Median overall survival was 66 months.
Altogether, 75 tumours (28%) in the study had an activating alteration of the PIK3CA gene.
Among the patients who regularly used NSAIDs, 93% used aspirin as a component of the NSAID regiment, and 73 per cent took aspirin exclusively.
Most of the regular users started on the aspirin therapy following their head and neck cancer diagnosis.
Researchers found that regular use of NSAIDs for at least six months provided “markedly prolonged” improved survival compared to non-use for patients whose PIK3CA gene was mutated or amplified — in these patients, NSAIDs raised overall five-year survival from 25 to 78%.
However, patients without alterations in their PIK3CA gene were no better off by taking NSAIDs.
Through analysis of both cell line and mouse studies, the researchers speculated that NSAIDs likely blocked tumour growth by reducing the production of an inflammatory molecule called prostaglandin E2.