Anti-inflammatory Agents for Breast Cancer: Case Closed or Is the Jury Still Out?
Mené sur 2 639 patientes atteintes d'un cancer du sein ERBB2- (âge médian : 55,2 ans), cet essai de phase III évalue l'efficacité, du point de vue de la survie sans maladie, et la toxicité du célécoxib en traitement adjuvant
Inflammation is one of the hallmarks of cancer. Preclinical work demonstrates that inflammation is associated with malignant transformation, tumor growth, and the development of metastasis. In observational studies of humans, inflammatory biomarkers were found to be associated with an increased risk of developing breast cancer and other cancers as well as poor outcomes for individuals who received a diagnosis of early-stage disease. Observational studies have also found an association between use of anti-inflammatory agents, such as aspirin, and a lower risk of developing breast cancer and other cancers; a recent meta-analysis of 42 reports, including 99 769 individuals, demonstrated a significant decrease in breast cancer risk with aspirin use (relative risk [RR], 0.92; 95% CI, 0.89-0.96). Randomized clinical trials testing the effect of aspirin on cardiovascular disease have also suggested that aspirin use may lower the risk of developing and dying from cancer. A pooled analysis of randomized clinical trials testing the effect of aspirin use on the incidence of cardiovascular disease demonstrated that individuals randomly assigned to receive aspirin were at lower risk of receiving a diagnosis of de novo metastatic adenocarcinoma (RR, 0.52; 95% CI, 0.35-0.75) or of developing metastases after initial diagnosis of an adenocarcinoma (RR, 0.31; 95% CI, 0.28-0.72) compared with individuals randomly assigned to receive placebo. Examination of case fatality by individual cancers was hampered by small numbers, but there was a suggestion of reduced case fatality for breast cancer (RR, 0.16; 95% CI, 0.02-1.19).
JAMA Oncology , éditorial, 2020