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NSAID use up-regulates local inflammatory response in colorectal cancer
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ORLANDO, Fla. — Patients with colorectal cancer who were prescribed aspirin alone or in combination with statins before diagnosis had increased tumor infiltration of T-lymphocytes in a study presented at Digestive Disease Week.
Researchers performed a retrospective case note review of 434 patients with colorectal cancer (CRC) and associated inflammatory responses, including 164 patients with available data on local inflammatory response. Patients who received prescriptions for aspirin or statins and aspirin in combination before diagnosis were compared with those who did not to determine the effect of either or both treatments on systemic and local inflammation.
“Increasing evidence suggests a role for NSAIDs, including aspirin and statins, as adjuvant treatment in colorectal cancer, with reduced recurrence and improved survival in long-term users,” the researchers wrote. “Whether this is due to manipulation of CRC-associated inflammation is unclear.”
Aspirin or statin use did not significantly impact peritumoral inflammatory infiltrate as indicated by Klintrup-Mäkinen grade (P=.615). Use of aspirin alone and in combination with statins, however, was significantly associated with increased T-lymphocyte (CD3+) tumor infiltration overall (P=.014) and at the invasive margin (P=.032), particularly among patients with local disease (P=.007 for margin and overall infiltration).
Measures of systemic inflammatory response, including C-reactive protein concentrations greater than 10 mg/L, modified Glasgow Prognostic Score and a neutrophil:lymphocyte ratio greater than 5, did not differ according to aspirin or statin use.
“We’re increasingly becoming aware that systemic and local inflammation are important determinants of survival in colorectal cancer, and a number of other cancers,” James Hugh Park, MBChB, colorectal clinical research fellow at the University of Glasgow, told Healio.com. “We need to start tailoring our therapy by using agents that will affect systemic and local inflammation. This study suggests that prediagnosis use of aspirin and statins may up-regulate local inflammatory responses in patients with colorectal cancer, which may potentially have a survival benefit. It suggests these agents may have a role in adjuvant treatment of colorectal cancer.”
For more information:
Park JH. Tu1516: Pre-Diagnosis Aspirin and Statin Use Up-Regulates the Local Inflammatory Response in Colorectal Cancer: Implications for Neoadjuvant Treatment. Presented at: Digestive Disease Week 2013; May 18-21, Orlando, Fla.