NSAID use can reduce breast cancer recurrence in overweight, obese women

Overweight and obese postmenopausal breast cancer patients taking aromatase inhibitors may gain a significant benefit by adding nonsteroidal anti-inflammatory drugs (NSAIDs) to their treatment, according to a study published in the August 14 issue of Cancer Research.

Heart risk raised in women regularly using NSAIDs

Based upon preclinical mechanistic studies, cancer researcher Linda deGraffenried of The University of Texas at Austin and colleagues conducted a retrospective analysis of patients seen between 1997 and 2011 at the San Antonio UT Health Science Center Cancer Therapy Research Center and START Center for Cancer Care. Patients with ER positive disease treated with aromatase inhibitors were evaluated for recurrence and time to progression in context of NSAID use.

The researchers determined that NSAID use reduces the recurrence rate of the most common form of breast cancer, ERα 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

“These studies show promise for using low-cost/low-toxicity NSAIDs for a growing subset of breast cancer patients,” deGraffenried said. “Inflammation is probably a much greater driver of cancer progression than we have originally believed, and limitation of inflammatory pathways may provide a significant benefit to numerous cancer types, not just breast cancer."

The results are preliminary, and studies are being conducted to confirm these initial findings, according to the researchers.

“Overweight or obese women diagnosed with breast cancer are facing a worse prognosis than normal-weight women,” deGraffenried said in a press release. “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 medical records of 440 breast cancer patients, comparing the prognoses of those who took NSAIDs with those who didn't.

A second study was designed to examine how breast cancer cells behave in the body. By bathing ERα positive breast cancer cells in blood serum from obese women, they hoped 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 known, the researchers believe that inflammation plays a pivotal role. Their findings also suggest inflammation negatively affects the effectiveness of aromatase inhibitors, a class of cancer drugs commonly prescribed to prevent cancer recurrence.

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

This study was supported by the United States Department of Defense, Breast Cancer Research Program and by the National Cancer Institute.