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NSAIDs Benefit Overweight Breast Cancer Patients

Study finds delayed disease recurrence

Researchers have determined that postmenopausal overweight or obese breast cancer patients receiving hormone therapy as part of their treatment and who use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, have significantly lower breast cancer recurrence rates and a sizable delay in time to cancer recurrence.

The findings, published August 14 in Cancer Research, suggest a new possibility for reducing the incidence of breast cancer recurrence among overweight and obese postmenopausal women, who have a comparatively higher risk of recurrence.

Using a retrospective analysis of human subjects and cell cultures, the researchers determined that NSAID use reduces the recurrence rate of the most common form of breast cancer — estrogen receptor-alpha (ER-alpha)–positive breast cancer — by 50% and extends patients’ disease-free period by more than 2 years. ER-positive breast cancers, which grow in response to exposure to the hormone estrogen, account for about 75% of diagnoses.

Cancer researcher Dr. Linda deGraffenried of the University of Texas at Austin designed the study. She and her colleagues caution that the results are preliminary.

“Overweight or obese women diagnosed with breast cancer are facing a worse prognosis than normal-weight women,” deGraffenried said. “We believe that obese women are facing a different disease. There are changes at the molecular level. We seek to modulate the disease- promoting effects of obesity.”

The investigators first examined the medical records of 440 breast cancer patients and compared the prognoses of those who took NSAIDs with those who did not.

The researchers then conducted a second study to determine how breast cancer cells behave in the body. By bathing ER-alpha–positive breast cancer cells in blood serum from obese women, they sought to mimic the environment that encourages tumors to grow, proliferate, and metastasize.

Although the mechanism causing breast cancer in obese women to be more aggressive and less responsive to treatment is not completely understood, the researchers believe that inflammation plays a pivotal role. Their findings also suggest that inflammation negatively affects the effectiveness of aromatase inhibitors, a class of cancer drugs commonly prescribed to prevent cancer recurrence.

“Clinicians are finding that the five-year recurrence rate for postmenopausal women is much higher on aromatase inhibitors when the patient is obese,” deGraffenried said. “We would like to identify which women are most likely to benefit from interventions like adding NSAIDs to treatment regimens.”

Dr. Laura Bowers, who led the cell-culture segment of the study, suggests that overweight or obese postmenopausal women — those at greater risk for the development of breast cancer — might benefit from taking low-dose aspirin daily. “What this study does is present great promise that a fairly inexpensive and nontoxic agent might benefit obese and overweight breast cancer patients who are at a higher risk of aromatase inhibitor failure — but further studies are needed to confirm these results,” Bowers said.

The research team is planning a larger prospective study to identify disease biomarkers and to monitor patients’ responses to the addition of NSAIDs to breast cancer treatment.

Source: University of Texas at Austin; August 14, 2014.

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