Certain Home Medications May Improve Survival After Locoregional Therapy

Taking aspirin, other nonsteroidal anti-inflammatory (NSAID) drugs, or beta blockers at the time of liver tumor embolization is linked with better survival rates, according to an abstract presented at the 2017 World Conference on Interventional Oncology in Boston, Massachusetts. 

Researchers retrospectively reviewed data on 1,092 patients who underwent 2,032 liver tumor embolization, radioembolization, and ablation procedures from June 2009 to April 2016.

Among the data collected, it was noted whether patients were taking 29 common prescription or nonprescription medications or medication classes that were indicated for conditions other than their cancer diagnosis. Other data analyzed included pathology, hepatocellular carcinoma (HCC) stage, neuroendocrine tumor grade, initial locoregional therapy, overall survival after initial locoregional therapy, Child-Pugh score, Eastern Cooperative Oncology Group performance status, and Charlson comorbidity index.

Most of the patients had HCC (30%), colorectal liver metastases (23%), or neuroendocrine tumor (20%), and approximately 60% of patients underwent transarterial embolization as their first procedure. For 14% of patients, the initial procedure was radioembolization, while 26% of patients underwent ablation as their initial procedure.

The data showed that survival rates were better when beta blockers, aspirin, other NSAIDs, proton pump inhibitors, or antivirals for hepatitis C virus or hepatitis B virus were taken at the same time as HCC embolization.

The researchers speculated that the improved survival associated with aspirin and NSAIDs could be “due to an immunomodulatory, anti-angiogenic, or anti-glycolytic mechanism.”

They cautioned that although beta-blockers were associated with improved survival, this association was not seen in other anti-hyperintensive medications. The reasons underlying the improvement in survival with beta blockers could be “decreased portal flow, decreased tumor stress response, or cardioprotective effects,” the investigators wrote.

They also noted that the improved survival effect might be specific to HCC, as there were no survival differences observed with aspirin and beta blockers after embolization of neuroendocrine tumor or radioembolization of colorectal liver metastases.

Reference

Boas FE, Ziv E, Yarmohammadi H, et al. Adjuvant medications that improve survival after locoregional therapy. World Conference on Interventional Oncology. June 8-11,2017.