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Real-World Studies Link Nonsteroidal Anti-inflammatory Drug Use to Improved Overall Lung Cancer Survival

Jason Roszik1,2, J Jack Lee3, Yi-Hung Wu3

  • 1Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030.

Cancer Research Communications
|July 14, 2022
PubMed

Insights

Nonsteroidal anti-inflammatory drugs (NSAIDs) significantly improve overall survival (OS) for non-small cell lung cancer (NSCLC) patients. Real-world data confirm NSAID use is linked to better outcomes, regardless of patient characteristics.

Area of Science:

  • Oncology
  • Pharmacology
  • Epidemiology

Background:

  • Inflammation is a recognized hallmark of cancer.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) have demonstrated improved overall survival (OS) in specific cancer types.
  • The impact of NSAIDs on non-small cell lung cancer (NSCLC) survival requires further real-world investigation.

Purpose of the Study:

  • To evaluate the association between NSAID usage and OS in patients with NSCLC.
  • To analyze real-world data from two independent healthcare systems to confirm findings.
  • To explore if NSAID benefits in NSCLC are influenced by prognostic factors like tobacco use, gender, race, or BMI.

Main Methods:

  • Retrospective analysis of clinical databases from MD Anderson Cancer Center (MDACC) and Georgetown-MedStar health system.
  • Extraction of structured and unstructured data from electronic health records (EHRs) using natural language processing (NLP).
  • Statistical analysis including survival assessments, stratified analyses by stage and histopathology, multivariable assessment, and landmark analyses to mitigate bias.

Main Results:

  • NSAID use was statistically significantly associated with increased NSCLC survival in both the MDACC (5-year OS 29.7% vs. 13.1%) and Georgetown cohorts.
  • NSAID users demonstrated a survival benefit of 11.6 months in restricted mean survival time.
  • The survival benefits persisted across different stages, histopathology, and were independent of tobacco use, gender, race, or BMI.

Conclusions:

  • Real-world NSAID usage is independently associated with significantly increased NSCLC survival.
  • Findings were robust, confirmed across two independent cohorts and validated by rigorous analytical methods.
  • These results support future randomized trials investigating NSAIDs for lung cancer treatment.
Keywords:
NSAIDslung canceroverall survivalreal-world data

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