Common Pain Reliever Can Improve Survival in Head and Neck Cancer

Researchers Find Some Cancer Cell Lines are More Sensitive to NSAID Treatment

By Elizabeth Fernandez | UCSF.edu | January 24, 2019

Jennifer R. Grandis, MD, senior author of the study.

Jennifer R. Grandis, MD, senior author of the study.

Regular use of a common type of medication, such as aspirin and ibuprofen, significantly improves survival for a third or more patients with head and neck cancer, a new study led by UC San Francisco has found. 

Non-steroidal anti-inflammatory drugs, or NSAIDs, improved the overall five-year survival rate from 25 percent to 78 percent 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 tumor, was unaffected by NSAID use.  

This is 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 may indicate a clear, biological reason to implement NSAID therapy in certain cases of the disease, said the authors. 

The paper is published January 25, 2019 in the Journal of Experimental Medicine

“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 Jennifer R. Grandis, MD, a UCSF professor of otolaryngology, head and neck surgery, and senior author of the paper. 

“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 percent of all tumors 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 tumors. 

Head and neck squamous cell carcinoma is a complex malignancy that carries a poor prognosis: the five-year survival rate is about 45 percent. According to the American Cancer Society, head and neck cancer accounts for approximately 4 percent 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. 

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. 

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