Common pain relievers can improve head, neck cancer survival — Study

A new study has revealed that regular use of a common type of medication such as aspirin and ibuprofen significantly improves survival for patients with head and neck cancer. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the overall five-year survival rate from 25 to 78 per cent for patients whose cancer contained a specific altered gene known as […]

A new study has revealed that regular use of a common type of medication such as aspirin and ibuprofen significantly improves survival for patients with head and neck cancer.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the overall five-year survival rate from 25 to 78 per cent for patients whose cancer contained a specific altered gene known as PIK3CA, the researchers reported.

The survival for patients whose gene was not altered in their tumour was unaffected by NSAID use.

The authors said this was the first study to show a strong clinical advantage of regular NSAID use for head and neck cancer patients with mutations in the PIK3CA gene and might indicate a clear and biological reason to implement NSAID therapy in certain cases of the disease. The results of the study was published in the Journal of Experimental Medicine.

The senior author and a Professor of Otolaryngology (head and neck surgery) at the University of Califonia in San Francisco, Jennifer Grandis, said their results suggested that the use of NSAIDs could significantly improve outcomes for not only head and neck cancer patients, but also patients with other cancers that contained the PIK3CA mutation.

“The magnitude of the apparent advantage is strong and could potentially have a positive impact on human health,” Grandis said.

She said within head and neck squamous cell carcinoma, PIK3CA was the most commonly altered oncogene, with 34 per cent of all tumours carrying mutations that activated the PIK3CA gene. In head and neck cancer associated with the human papillomavirus (HPV), PIK3CA is mutated in more than half of tumours.

“Head and neck squamous cell carcinoma is a complex malignancy that carries a poor prognosis: the five-year survival rate is about 45 per cent. According to the American Cancer Society, head and neck cancer accounts for approximately four per cent of all cancers in the United States, with an estimated 65,000 people developing it annually. While the disease can occur in the young, most patients are above age 50 when diagnosed. Primary risk factors include smoking, alcohol use, and HPV infection,” she said.

NSAIDs, which include over-the-counter drugs such as ibuprofen and aspirin, are known to relieve pain and reduce inflammation, fever and blood clots. They are the most frequently prescribed medication for conditions such as arthritis.

In the new research, 266 patients from the University of Pittsburgh Medical Center whose tumours were surgically removed were investigated by the authors. The majority (84 per cent) smoked and 67 per cent received post-surgery chemotherapy and or radiotherapy. Median overall survival was 66 months.

Altogether, 75 tumours (28 per cent) in the study had an activating alteration of the PIK3CA gene.

Among the patients who regularly used NSAIDs, 93 per cent used aspirin as a component of the NSAID regiment and 73 per cent took aspirin exclusively. Most of the regular users started on the aspirin therapy following their head and neck cancer diagnoses.

The investigators learned that regular use of NSAIDs for at least six months provided “markedly prolonged” improved survival compared to non-use for patients whose PIK3CA gene was mutated or amplified – in these patients, NSAIDs raised overall five-year survival from 25 to 78 per cent.

However, patients without alterations in their PIK3CA gene were no better off by taking NSAIDs.

Grandis, a member of the UCSF Helen Diller Family Comprehensive Cancer Center, said NSAID use likely conferred a statistically and clinically significant advantage in overall survival in PIK3CA-altered head and neck cancer through direct interaction between the PI3K and COX pathways.