Real-world studies indicate NSAIDs improve lung cancer survival

Common drugs for controlling pain and inflammation – such as aspirin and ibuprofen – improved overall lung cancer survival by a statistically significant margin in a long-term study of patient medical records. This finding called for more definitive randomized clinical trials. 

Use of non-steroidal anti-inflammatory drugs (NSAIDs) was associated with a survival rate of 29.7 percent after five years, compared to 13.1 percent with nonuse. This held true regardless of gender, race, smoking status, and body mass index, according to the study published in Cancer Research Communications. The study extended previous research confirming the therapeutic benefit of NSAIDs in colorectal cancer. 

“If survival benefits after NSAID use are confirmed in future randomized clinical trials, this could advance lung cancer practice,” noted the research team, led by Ethan Dmitrovsky, M.D., dIrector of the Frederick National Laboratory and president of Leidos Biomedical Research. “This possibility is facilitated by the fact that NSAIDs are relatively inexpensive, cost-effective, and often available without a prescription.” 

The real-world study analyzed de-identified electronic health records from The University of Texas MD Anderson Cancer Center (33,162 patients between 1987 and 2015) and Georgetown-MedStar Health System (4,497 patients from 2000 to 2019) using natural language processing and population-based approaches.  

NSAID use was defined as a regimen given at the time of diagnosis. Subsequent data were collected through retrospective review of medical records. NSAIDs included in the study: low-dose aspirin, regular-dose aspirin, celecoxib, ibuprofen, naproxen, ketorolac and others. 

In MD Anderson patients who used only one NSAID type, statistically significant associations were found for low-dose aspirin, regular-dose aspirin, celecoxib, ibuprofen, and ketorolac. All patients who used NSAIDs – African American/Black, Caucasian/Non-Hispanic White, and Hispanic – lived longer than nonusers. 

The natural language processing approach was independently validated in the Georgetown-MedStar Health System cohort. The study had some limitations, such as the inability to assess which NSAID was most effective. Dose and treatment length were also unknown. And the study did not determine the precise mechanism responsible for the associated survival benefits. 

Yet the study involved two large study cohorts followed over many years and there was observed a statistically significant association between NSAID use and cancer survival.  

“Randomized trials would help establish the therapeutic value of specific NSAIDs in improving survival in lung and potentially other cancers,” the researchers concluded. Lung cancer is the most common cause of cancer deaths in the United States. It is expected to claim the lives of about 130,000 men and women in 2022, according to the American Cancer Society.