Naveed Saleh, MD, MS, for MDLinx | October 22, 2019
NSAIDs, including aspirin, may lengthen overall survival (OS) in patients receiving treatment for head/neck or lung cancers, according to the results from a dyad of studies presented at the American Society for Therapeutic Radiation Oncology (ASTRO) Annual Meeting, Chicago, IL, September 15–18.
“We have now started to give all of our roughly 1,000 follow-up head-and-neck cancer patients this information and started to encourage them to have a discussion with their doctors about starting aspirin daily, as long as they are not on blood thinners,” said principal investigator of both studies, Anurag Singh, MD, Roswell Park Comprehensive Cancer Center, Buffalo, NY. “This is an exciting new avenue we are researching in other cancer types and designing new prospective clinical trials for.”
In a retrospective study on head and neck cancer, Dr. Singh and colleagues mined data from 460 patients with head and neck squamous cell carcinoma (HNSCC) who were treated with chemoradiation from 2005 to 2017. Of these patients, 201 (44%) received NSAIDs during treatment. According to findings, NSAIDs were related to better OS, while overall clinical stage (0.022), clinical T stage (0.006), current/former smoking (< 0.001), and oral cavity primary tumor (0.02) were linked to worse survival.
Furthermore, OS at 5 and 10 years was significantly better among those taking NSAIDs compared with those who did not take NSAIDs while receiving chemoradiotherapy (64% vs 56% and 38% vs 30%, respectively). Importantly, NSAID use was not tied to enhanced treatment response.
In the retrospective study on lung cancer, Dr. Singh and fellow researchers examined the effect of aspirin use on patients (median age: 76 years) with non-small cell lung cancer receiving stereotactic body radiation therapy for early stage disease. Of the 164 eligible patients evaluated at follow-up (median 18.2 months), 74 (45%) were on NSAIDS, among whom 70 (95%) were taking aspirin. All patients had undergone stereotactic body radiation therapy between 2007 and 2015.
Although there was no statistically significant difference in OS with concurrent NSAID use vs no NSAID (log rank P = 0.12), Dr. Singh and colleagues did observe a near-significant lengthening of OS among concurrent aspirin users compared with non-aspirin users.
“These studies provide further support for a growing body of literature that demonstrates a benefit for use of non-steroidal anti-inflammatory drugs, such as aspirin, by cancer patients,” stated lead author of the lung cancer study, Gregory Hermann, MD. “Although clinical trials are needed to make a definitive recommendation, we encourage patients to have a discussion with their doctor regarding the risks and potential benefits of aspirin use.”