NSAIDs may lower breast cancer recurrence in overweight and obese women

Recurrence of hormone-related breast cancer was reduced by 50% in overweight and obese women who regularly used aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), according to newly published data.

“Our studies suggest that limiting inflammatory signaling may be an effective, less toxic approach to altering the cancer-promoting effects of obesity and improving patient response to hormone therapy,” said Linda A. deGraffenried, PhD, associate professor of nutritional sciences at The University of Texas in Austin. The study was published in Cancer Research (2014; doi:10.1158/0008-5472.CAN-13-3603).

The study found that women whose body mass index (BMI) was greater than 30 kg/m2 and who had estrogen receptor alpha (ERα)-positive breast cancer had a 52% lower rate of recurrence and a 28-month delay in time to recurrence if they were taking aspirin or other NSAIDs.

“These results suggest that NSAIDs may improve response to hormone therapy, thereby allowing more women to remain on hormone therapy rather than needing to change to chemotherapy and deal with the associated side effects and complications,” said deGraffenried. “However, these results are preliminary and patients should never undertake any treatment without consulting with their physician.”

Using blood from obese patients, deGraffenried and colleagues conducted experiments in the laboratory to recreate a tumor environment containing cancer cells, fat cells, and the immune cells that promote inflammation. They found that the factors associated with obesity initiate a network of signaling within the tumor environment to promote growth and resistance to therapy.

“These studies show that the greatest benefit from aspirin [and other NSAIDs] will be in those with a disease driven by inflammation, and not just obesity,” explained DeGraffenried.

Researchers used data from 440 women with invasive, ERα-positive breast cancer and treated at The University of Texas Health Science Center and the START Center for Cancer Care clinic, both in San Antonio, Texas, between 1987 and 2011.

Of the women studied, 58.5% were obese and 25.8% were overweight. About 81% took aspirin, and the rest took another NSAID. Approximately 42% and 25%, respectively, took statins and omega-3 fatty acid.

There was an indication of protection from aspirin and other NSAIDs even after controlling for statins and omega-3 fatty acid use, which also have anti-inflammatory effects.

This study was funded by the US Department of Defense, the Breast Cancer Research Program of the Congressionally Directed Medical Research Programs, and the National Cancer Institute. deGraffenried declares no conflicts of interest.

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