OTC Pain Drugs May Increase Colorectal Cancer Survival

Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically sold over the counter to treat headaches, mild pain, and fever. New findings from a study published by the Journal of Clinical Oncology suggests that NSAIDs may also benefit long-term survivors of colorectal cancer (CRC).

The authors discovered that the use of NSAIDs reduced all-cause mortality among CRC survivors by 25%, according to the study.

Additionally, the investigators found that NSAIDs are particularly beneficial for patients without KRAS mutations in the tumor. Among these patients, NSAID use was linked to a survival benefit of 40%.

"Several other studies have shown an association between NSAIDs and preventing CRC, but this is the first to look so thoroughly at how timing of NSAID use relative to diagnosis and tumor type could make a big difference in survival," said senior author Polly Newcomb, PhD. "These results should spark conversations between patients and their doctors. NSAID use is an accepted practice to prevent cardiovascular disease, and their use as a tool against cancer merits similar consideration and study."

CRC is the second leading cause of cancer-related deaths in the United States, with more than 70% of patients having tumors without KRAS mutations. These findings may be applicable to the vast majority of CRC survivors, according to the study authors.

Included in the study were 2419 newly diagnosed patients included in the Colon Cancer Family Registry, which collected data regarding lifestyle, family history, and medical information.

Patients were divided into 4 groups: patients who took NSAIDs before and after diagnosis, patients who used the drugs after diagnosis, patients who stopped using NSAIDs after diagnosis, and patients who did not use the drugs. The authors found that 41% of patients regularly took NSAIDs, including aspirin and non-aspirin.

The researchers also conducted tumor-marker tests by genotyping patient samples to determine mutations and type of cancer, according to the study.

The investigators controlled for smoking status, family history, age, and other relevant factors. Then, they conducted statistical analyses to evaluate the link between NSAIDs to overall and cancer-related survival.

The authors noted differences in type of NSAID and outcome, which they hypothesized was due to varying patterns of use rather than the type of drug used, according to the study.

Limitations of the study include self-reporting of NSAID use and that the findings may only be applicable to this population.

The authors recommend that additional studies include a more diverse patient group, according to the study.

"We now have a better idea of how NSAID use may benefit a subset of patients diagnosed with colorectal cancer," said study first author Xinwei Hua, PhD. "Next, we need to understand more precisely what the optimal timing, dose and duration of NSAID use should be among patients with KRAS wild-type tumors. We are just beginning to understand the biology underpinning NSAID use on the tumor's molecular pathways, and it's very exciting."