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NSAID Use May Reduce Risk of Breast Cancer Recurrence in Overweight and Obese Women

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Key Points

  • Obesity is associated with a worse breast cancer prognosis and elevated levels of inflammation, including greater COX-2 expression and activity in adipose-infiltrating macrophages.
  • Overweight and obese women who regularly used aspirin or other COX-2–inhibiting NSAIDs, had a 52% lower recurrence rate of hormone-related breast cancer and a 28-month delay in time to recurrence than non-NSAID users.
  • Limiting inflammatory mediators may be an effective way to alter the cancer-promoting effects of obesity and improve patient response to hormone therapy.

Obesity is associated with a worse breast cancer prognosis and elevated levels of inflammation, including greater cyclooxygenase-2 (COX-2) expression and activity in adipose-infiltrating macrophages. Data from a new study finds that overweight and obese women who regularly used aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), which inhibit COX-2 expression, had a 52% lower recurrence rate of hormone-related breast cancer and a 28-month delay in time to recurrence compared with non-NSAID users.

The study results suggest that limiting inflammatory mediators may be an effective way to alter the cancer-promoting effects of obesity and improve patient response to hormone therapy. The study by Bowers et al is published in Cancer Research.

Study Methodology

Researchers reviewed the medical records of 440 women diagnosed with invasive estrogen receptor alpha–positive breast cancer who were treated at The University of Texas Health Science Center and the START Center for Cancer Care clinic in San Antonio, between 1987 and 2011. The majority of the patients were overweight (average body mass index [BMI] > 25) or obese (average BMI > 30), 25.8% and 58.5%, respectively. About 81% took aspirin, and the rest took another NSAID. The NSAID users were more likely to be older, postmenopausal, and diabetic. About 42% and 25% took statins and omega-3 fatty acid, respectively.

Results

The researchers found that the recurrence rate in NSAID users was 52% lower than non-NSAID users and that NSAID users remained disease-free for an average of 78.5 months, whereas nonusers averaged 50.6 months, a difference of more than 2 years.

Using blood from the obese patients, the researchers 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.

“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 at Austin, said in a statement.

Dr. deGraffenried is the corresponding author for the Cancer Research article.

The study was funded by the U.S. Department of Defense, the Breast Cancer Research Program of the Congressionally Directed Medical Research Programs, and the National Cancer Institute.

Study author Muralidhar Beeram, MD, has received speakers’ bureau honoraria from Genentech, Inc. The other study authors reported no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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