8 / 17
Page 45
allied
academies
Journal of Medical Oncology & Therapeutics | Volume 4
March 18-19, 2019 | London, UK
Oncology & Cancer Therapy
International Conference on
Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: New
findings and a review
Michael Retsky
Harvard TH Chan School of Public Health, USA
A
bimodal pattern of hazard of relapse among early stage
breast cancer patients has been identified in multiple
databases. Using computer simulation and access to a
very high quality database from Milan for patients treated
with mastectomy only, we proposed that relapses within
3 years of surgery are stimulated somehow by the surgical
procedure. Retrospective breast cancer data from a Brussels
anesthesiology group suggested a plausible mechanism. Use
of ketorolac, a common NSAID analgesic used before surgery
was associated with far superior disease-free survival.
The expected prominent early relapse events in months
9-18 are reduced 5-fold. Transient systemic inflammation
accompanying surgery (identified by IL-6 in serum) could
facilitate angiogenesis of dormant micrometastases and
proliferation of dormant single cells and could have been
effectively blocked by the perioperative NSAID. If this
observation holds up to further scrutiny, it could mean that
the simple use of this safe, inexpensive and effective anti-
inflammatory agent at surgery might eliminate early relapses
and reduce mortality by 25 to 50%. This hypothesis has been
recently confirmed in a mouse model by Krall et al in Science
Translational Medicine 2018 and a second retrospective
study by Desmedt et al in JNCI 2018. Post-operative bleeding
is a major concern with perioperative NSAIDs however
tranexamic acid has been found to reduce such bleeding by
39% in a clinical trial by Ausen et al in BJ Surg 2018.
e:
michael.retsky@gmail.comNotes: