Regular use of a common type of medication such as aspirin and ibuprofen significantly improves the survival rate for a third or more patients with head and neck cancer, a new study has found.
Non-steroidal anti-inflammatory drugs, or NSAIDs, for at least six months provided “markedly prolonged” improved five-year survival rate from 25 per cent to 78 per cent for patients whose cancer contained a specific altered gene, known as PIK3CA, researchers from the University of California-San Francisco (UCSF) reported.
The survival rate for patients whose gene was not altered in their tumour was unaffected by NSAID use.
“Our results suggest 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,” said UCSF professor Jennifer R. Grandis.
“The magnitude of the apparent advantage is strong, and could potentially have a positive impact on human health,” Grandis said.
Within head and neck squamous cell carcinoma, PIK3CA is the most commonly altered oncogene, with 34 per cent of all tumours carrying mutations that activate the PIK3CA gene.
In head and neck cancer associated with the human papillomavirus (HPV), PIK3CA is mutated in more than half of tumours.
In the research, published in the Journal of Experimental Medicine, 266 patients from the University of Pittsburgh Medical Center whose tumours were surgically removed were investigated. 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 diagnosis.
Through analysis of both cell line and mouse studies, the researchers speculated that NSAIDs likely blocked tumour growth by reducing the production of an inflammatory molecule called prostaglandin E2.
The researchers pointed out that their results need to be corroborated in a prospective trial.
“NSAID use likely confers 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,” said Grandis.