NSAIDs May Increase Survival in Certain Head and Neck Cancers

Advantage for Patients with PIK3CA Mutations Regardless of HPV Status

The regular use of common nonsteroidal anti-inflammatory drugs (NSAIDs) may buy time for patients with head and neck cancers with alterations in the PIK3CA gene, according to a study.

In a study of 266 patients with head and neck squamous cell carcinoma (HNSCC) with PIK3CA mutations or amplification, there was a significantly prolonged overall survival (OS) (hazard ratio [HR], 0.31; 95% CI, 0.14–0.69; P = 0.0043) with regular use of NSAIDs for at least six months after curative treatment. 

Disease-specific survival was also found in patients taking NSAIDs versus non-regular NSAID users. This effect was observed regardless of human papillomavirus (HPV) infection, which is a primary risk factor for HNSCC. 

The majority (67%) of the group received adjuvant chemotherapy, radiotherapy, or both, and these therapies did not alter the NSAIDs’ effect on PIK3CA outcomes.

Among the regular NSAID users, the most common NSAIDs used were aspirin (74%), ibuprofen (24.2%), naproxen (7.1%), and celecoxib (3.0%). 

Based on the current study and preclinical studies using four different NSAIDs, there is no indication that any particular NSAID is more protective than another, noted the researchers.

A future trial will include patients who have had curative therapy and whose primary tumors tested positive for altered PIK3CArandomized to placebo or baby aspirin for two years. Patients in a second trial will receive a COX-2 inhibitor before curative surgery, and investigators will examine whether the NSAID has a favorable impact on the immune system as well as a direct anti-tumor effect.

Source: MedPageToday, January 28, 2019