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Pulumati A, Algarin YA, Jaalouk D, Kim S, Latta S, Nouri K. Aspirin as a chemopreventive agent for cutaneous melanoma: a literature review. Arch Dermatol Res 2024; 316:367. [PMID: 38850411 DOI: 10.1007/s00403-024-03056-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/04/2024] [Accepted: 04/26/2024] [Indexed: 06/10/2024]
Abstract
Rising melanoma rates have spurred interest in preventive strategies. Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, show potential in reducing cancer risks. NSAIDs act on cyclooxygenase (COX) enzymes, impacting COX-2 associated with inflammation and cancer progression. This paper explores aspirin's role in cutaneous melanoma prevention, elucidating its mechanisms and acknowledging varying literature outcomes. Rather than providing conclusive recommendations, the review emphasizes the influence of individual factors, contributing to the ongoing dialogue on aspirin's complexities in melanoma prevention. A PubMed search using "Aspirin" AND "Cutaneous melanoma" yielded relevant English-language, peer-reviewed studies. Selection criteria focused exclusively on skin cancers, specifically cutaneous melanoma. Exclusions included studies covering various cancers, some non-dermatologic, and those not evaluating aspirin use independently but in conjunction with NSAIDs. The potential chemopreventive effects of aspirin and NSAIDs against melanoma have gained attention due to their association with a reduced risk of various cancers including gastric, colorectal, and breast. By inhibiting COX enzymes and the NF-κB pathway, these agents theoretically slow malignant cell activities, presenting a prospect for cancer prevention. Aspirin exhibits noteworthy effects, depleting growth-stimulating hormones, generating reactive oxygen species harmful to cancerous cells, and inhibiting COX-2 linked to cancer progression. Limited literature suggests survival benefits with aspirin use in stage II and III melanoma, possibly due to slowing disease progression, evident in smaller Breslow depths. Gender-specific responses to aspirin are notable, with some studies reporting a stronger chemopreventive correlation in females. It's crucial to note that geographic disparities, demographic cohorts, and individual-specific factors are confounding variables that may contribute to conflicting findings regarding aspirin's impact on melanoma. The association between aspirin use and melanoma risk is complex, with conflicting findings across diverse populations. Although it appears that more studies suggest a protective role for aspirin rather than not, evidence lacks consistency. Factors such as gender, geography, race, sun exposure, and health conditions play a role in shaping these varied outcomes, necessitating large-scale, prospective studies research and standardized parameters for more conclusive insights that may help guide tailored clinical strategies for melanoma prevention.
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Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | - Yanci A Algarin
- Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Dana Jaalouk
- Florida State University College of Medicine, Tallahassee, FL, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Sarah Kim
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Steven Latta
- Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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Russomanno K, Abdel Azim S, Patel VA. Immunomodulators for Non-Melanoma Skin Cancers: Updated Perspectives. Clin Cosmet Investig Dermatol 2023; 16:1025-1045. [PMID: 37095898 PMCID: PMC10122480 DOI: 10.2147/ccid.s362171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
Non-melanoma skin cancers (NMSCs) are the most common cancers worldwide and may be associated with significant morbidity and mortality, especially in immunosuppressed populations. Successful management of NMSC must take primary, secondary and tertiary prevention strategies into consideration. In response to an improved understanding of the pathophysiology of NMSC and associated risk factors, multiple systemic and topical immunomodulatory drugs have been developed and integrated into clinical practice. Many of these drugs are efficacious in the prevention and treatment of precursor lesions (actinic keratoses; AKs), low-risk NMSC, and advanced disease. The identification of patients at high risk for the development of NMSC is critical in reducing disease morbidity. Understanding the various treatment options available and their comparative effectiveness is paramount for developing a personalized treatment regimen for such patients. This review article provides an updated overview of the various topical and systemic immunomodulatory drugs available for the prevention and treatment of NMSC, and the published data supporting their use in clinical practice.
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Affiliation(s)
- Kristen Russomanno
- Department of Dermatology, Medstar Georgetown University Hospital/Medstar Medical Group, Washington, DC, USA
| | - Sara Abdel Azim
- School of Medicine, Georgetown University, Washington, DC, USA
| | - Vishal A Patel
- Department of Dermatology, George Washington University, Washington, DC, USA
- Correspondence: Vishal A Patel, Department of Dermatology, George Washington University, 2150 Pennsylvania Avenue NW, 2nd Floor, Washington, DC, 20037, USA, Tel +1 202 741 2600, Email
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Frankel L, Ardeljan AD, Takabe K, Rashid OM. The Association Between Aspirin and Basal Cell Carcinoma: A Clinical and Financial Analysis. World J Oncol 2022; 13:343-349. [PMID: 36660204 PMCID: PMC9822678 DOI: 10.14740/wjon1533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/05/2022] [Indexed: 12/26/2022] Open
Abstract
Background Nonmelanoma skin cancer (NMSC) is the most common malignancy. Basal cell carcinoma (BCC) comprises about 80% of all NMSCs and its incidence continues to rise. Although BCC rarely leads to metastases or increased mortality, its effects on healthcare costs and quality of life are substantial. Aspirin may prevent the development of basal cell carcinoma (BCC) by the inhibition of cyclooxygenase (COX) enzymes, which are associated with carcinogenesis and inflammation. This study therefore examined the effect of aspirin on the risk of BCC, its clinical outcomes, and its treatment costs. Methods A retrospective study (2010 - 2018) was conducted using the Humana Health Insurance Database. International Classification of Disease ninth and 10th codes and National Drug Codes were used to identify BCC diagnoses and aspirin prescriptions. Patients were matched for age, sex, Charlson Comorbidity Score (CCI), and region of residence. Chi-squared, logistic regression, and odds ratio (OR) analyses were utilized to test for significance and to estimate relative risk. Results Aspirin use was associated with a decreased incidence of BCC in unmatched (OR = 0.658, 95% confidence interval (CI) 0.526 - 0.820) and matched (OR = 0.54, 95% CI 0.47 - 0.61) analyses. Aspirin was also associated with a decreased BCC risk when stratified by hypertension (P = 3.888 × 10-5), chronic obstructive pulmonary disease (COPD) (P = 0.014), diabetes (P = 0.049) and tobacco use (P = 0.017). Aspirin use was not associated with risk of BCC when stratified by obesity (P = 0.408). The average paid per patient for BCC treatment was significantly higher for patients in the aspirin use group than in the aspirin nonuse group (P = 0.0087). Conclusions While the high incidence and cost of treatment of BCC are demanding both clinically and financially, the low cost of aspirin and its widespread use may have vital implications for its preventative role in this disease. This study concluded that aspirin use was associated with a significantly decreased risk of BCC.
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Affiliation(s)
- Lexi Frankel
- Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Amalia D. Ardeljan
- Michael and Dianne Biennes Comprehensive Cancer Center, Holy Cross Health, Fort Lauderdale, FL, USA
| | - Kazuaki Takabe
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA,Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA
| | - Omar M. Rashid
- Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA,Michael and Dianne Biennes Comprehensive Cancer Center, Holy Cross Health, Fort Lauderdale, FL, USA,Leonard Miami School of Medicine, University of Miami, Miami, FL, USA,Massachusetts General Hospital, Boston, MA, USA,Broward Health, Fort Lauderdale, FL, USA,TopLine MD Alliance, Fort Lauderdale, FL, USA,Memorial Health, Pembroke Pines, FL, USA,Delray Medical Center, Delray, FL, USA,Corresponding Author: Omar M. Rashid, Complex General Surgical Oncology, General & Robotic Surgery, TopLine MD Alliance, Fort Lauderdale, FL 33308, USA.
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Mai JZ, Kitahara CM, Sargen MR, Little MP, Alexander BH, Linet MS, Tucker MA, Cahoon EK. Use of Nonsteroidal Anti-Inflammatory Drugs and Incidence of Melanoma in the United States Radiologic Technologists Study. Cancer Prev Res (Phila) 2022; 15:727-732. [PMID: 35902885 PMCID: PMC9633366 DOI: 10.1158/1940-6207.capr-22-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 01/31/2023]
Abstract
Although NSAIDs have been associated with both reduced and increased cutaneous melanoma risk, few studies have examined these associations by ultraviolet radiation (UVR) or personal sun-sensitivity. We examined the associations between NSAID use and first primary invasive cutaneous melanoma among 58,227 non-Hispanic white participants in the United States Radiologic Technologists cohort study. Poisson regression was used to calculate rate ratios (RR) and 95% likelihood-based confidence intervals (CI), adjusting for attained age, birth cohort, and ambient UVR. No significant association of melanoma was observed for any use of NSAIDs (RR, 0.87; 95% CI, 0.71-1.09). The relative risks of melanoma for the highest categories of aspirin and other NSAID use (≥5 times per month vs. none) were 0.93 (95% CI, 0.74-1.16) and 1.02 (95% CI, 0.83-1.25), respectively. Further analyses did not reveal dose-response for trends in frequency of NSAID use or interactions with sex, UVR, eye and hair color, and skin complexion. In this large nationwide study, NSAID use was not associated with melanoma risk. PREVENTION RELEVANCE NSAIDs have been associated with both reduced and increased melanoma risk. However, few studies have examined the role of UVR or personal sun-sensitivity on these associations. Our findings strengthen the evidence that NSAID use is not associated with melanoma risk, even in sun-sensitive subgroups.
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Affiliation(s)
- Jim Z. Mai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Michael R. Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Elizabeth K. Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
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Yan MK, Orchard SG, Adler NR, Wolfe R, McLean C, Rodríguez LM, Woods RL, Gibbs P, Chan AT, Haydon A, Mar VJ. Association between hypertension and cutaneous melanoma, and the effect of aspirin: extended follow-up of a large randomised controlled trial. Cancer Epidemiol 2022; 79:102173. [PMID: 35567859 PMCID: PMC10026004 DOI: 10.1016/j.canep.2022.102173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The association between hypertension and melanoma is unclear, and previous analyses of data from the ASPirin in Reducing Events in the Elderly (ASPREE) study demonstrated a reduced number of invasive melanoma events amongst aspirin-exposed hypertensive individuals. METHODS Data from the ASPREE study which included (1) the intervention period with a median follow-up of 4.7 years, and (2) the observational period with an additional 2 years follow-up, were combined for this analysis. Logistic regression analyses examined the association between baseline hypertension and treatment status and past melanoma history. Survival analyses examined the association between hypertension and melanoma risk, and the effect of aspirin across hypertension groups. Cox proportional hazards models were used to compare incidence across groups. RESULTS 19,114 participants (median age of 74 years) were randomised to daily 100 mg aspirin or placebo. At baseline, hypertension and past melanoma history were recorded in 14,195 and 685 individuals, respectively. After adjustment for confounders, hypertension was significantly associated with past melanoma history (OR=1.34, 95%CI: 1.11-1.62). In a prospective analysis, baseline hypertension was not associated with melanoma risk. However, aspirin was associated with a reduced risk of incident melanoma amongst individuals with uncontrolled hypertension (blood pressure ≥140/90 mmHg; HR=0.63, 95%CI 0.44-0.89), but not in those with controlled hypertension (HR=1.04, 95%CI 0.74-1.46). CONCLUSION Our results support a reduced melanoma incidence amongst individuals with uncontrolled hypertension exposed to aspirin. Additional studies are required to confirm these findings.
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Affiliation(s)
- Mabel K Yan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia; Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia.
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Nikki R Adler
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Catriona McLean
- Department of Anatomical Pathology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Luz María Rodríguez
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA; Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU) Department of Surgery, Bethesda, MD, USA
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Peter Gibbs
- The Walter & Eliza Hall Institute of Medical Research, University of Melbourne,1 G Royal Parade, Parkville, Victoria 3052, Australia
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Massachusetts, USA
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Victoria J Mar
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia; Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
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Yan MK, Orchard SG, Adler NR, Wolfe R, McLean C, Rodríguez LM, Woods RL, Gibbs P, Chan AT, Haydon A, Mar VJ. Effect of Aspirin on Melanoma Incidence in Older Persons: Extended Follow-up of a Large Randomized Double-blind Placebo-controlled Trial. Cancer Prev Res (Phila) 2022; 15:365-375. [PMID: 35395069 PMCID: PMC9167236 DOI: 10.1158/1940-6207.capr-21-0244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/17/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
The effects of aspirin on melanoma are unclear, with studies reporting conflicting results. Data from two periods of the ASPirin in Reducing Events in the Elderly (ASPREE) study; the randomized placebo-controlled trial period examining daily 100 mg aspirin in older adults with a median follow-up of 4.7 years, and the second period, an additional 2 years of observational follow-up, were utilized in this secondary analysis to examine whether aspirin exposure is associated with a reduced cutaneous melanoma incidence. All melanoma cases were adjudicated and Cox proportional hazards models were used to compare incidence between randomized treatment groups. ASPREE recruited 19,114 participants with a median age of 74 years. During the trial period, 170 individuals (76 aspirin, 94 placebo) developed an invasive melanoma, and no significant effect of aspirin was observed on incident melanoma [HR = 0.81; 95% confidence interval (CI), 0.60-1.10]. Including the additional 2 years of observational follow-up (median follow-up of 6.3 years), 268 individuals (119 aspirin, 149 placebo) developed an invasive melanoma, and similar results were observed (HR = 0.81; 95% CI, 0.63-1.03). A reduced number of events was observed with aspirin among females in a subgroup analysis (HR = 0.65; 95% CI, 0.44-0.92); however, the interaction effect with males (HR = 0.92; 95% CI, 0.68-1.25) was nonsignificant (P = 0.17). Our findings from this randomized trial do not provide strong support that aspirin is associated with a reduced risk of invasive melanoma in older individuals. Additional studies are required to further explore this relationship. PREVENTION RELEVANCE Melanoma prevention is an important strategy to improve outcomes and while preventive efforts have largely focused on sun protection, the role of potential chemopreventive agents such as aspirin warrants investigation.
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Affiliation(s)
- Mabel K Yan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
- Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC, 3004
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
| | - Nikki R Adler
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
| | - Catriona McLean
- Department of Anatomical Pathology, Alfred Health, 55 Commercial Road, Melbourne, VIC, 3004
| | - Luz María Rodríguez
- Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, MD, USA
- Walter Reed National Military Medical Center (WRNMM) Uniformed Services University (USU) Department of Surgery, Bethesda, MD, USA
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
| | - Peter Gibbs
- The Walter & Eliza Hall Institute of Medical Research, University of Melbourne,1G Royal Parade, Parkville, Victoria 3052
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Massachusetts, United States of America
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Health, 55 Commercial Road, Melbourne, VIC, 3004
| | - Victoria J Mar
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004
- Victorian Melanoma Service, Alfred Health, 55 Commercial Road, Melbourne, VIC, 3004
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Nasiri N, Babaei S, Moini A, Eftekhari-Yazdi P. Controlling Semi-Invasive Activity of Human Endometrial Stromal Cells by Inhibiting NF-kB Signaling Pathway Using Aloe-emodin and Aspirin. J Reprod Infertil 2022; 22:227-240. [PMID: 34987984 PMCID: PMC8669405 DOI: 10.18502/jri.v22i4.7648] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/11/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Inflammation and its master regulator, Nuclear Factor-kB (NF-kB), have been implicated in the development of endometriosis. Inhibition of NF-kB pathway using small molecules ameliorated disease progression and reduced the lesion size; nevertheless, the underlying mechanism is not fully understood. Therefore, this study, is an attempt to assess whether inhibiting NF-kB signaling by aloe-emodin (AE) or aspirin (Asp), as anti-inflammatory compounds, can suppresses the invasive activity of human endometrial stromal cells at stage IV endometriosis. Methods: The eutopic and healthy endometrial biopsies from a total of 8 infertile women with confirmed endometriosis and 8 women without endometriosis were digested and the single cells were cultured. Gene and protein markers of proliferation, migration, adhesion, and invasion of eutopic endometrial stromal cells (EuESCs) with and without treatment with AE or Asp, as well as control endometrial stromal cells (CESCs) was analyzed using q-PCR and immunofluorescence staining, respectively. Comparison between groups was performed using one-way ANOVA and the Bonferroni post hoc and p≤0.5 was considered statistically significant. Results: There was an association between NF-kB overexpression and higher proliferation/adhesion capacity in EuESCs. EuESCs (at stage IV endometriosis) displayed no invasive and migratory behaviors. Pre-treatment of EuESCs with AE or Asp significantly attenuated NF-kB expression and reduced proliferative, adhesive, invasive, and migratory activity of endometrial cells (p≤0.5). Conclusion: Eutopic endometrial stromal cells seem to have a semi-invasive activity which is largely suppressed by AE or Asp. It can be suggested that both Asp and AE (as potent NF-kB inhibitors) can be used as a supplement in conventional endometriosis treatments.
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Affiliation(s)
- Nahid Nasiri
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Sara Babaei
- Department of Developmental Biology, Factually of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Ashraf Moini
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Poopak Eftekhari-Yazdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Prego-Domínguez J, Takkouche B. Paracetamol Intake and Hematologic Malignancies: A Meta-Analysis of Observational Studies. J Clin Med 2021; 10:jcm10112429. [PMID: 34070784 PMCID: PMC8198062 DOI: 10.3390/jcm10112429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/12/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Hematologic malignancies cause more than half a million deaths every year worldwide. Analgesics were suggested as chemopreventive agents for several cancers but so far, results from individual studies about the relationship between paracetamol (acetaminophen) use and hematologic malignancies are conflicting. Therefore, we decided to perform a systematic review and meta-analysis. We retrieved studies published in any language by systematically searching Medline, Embase, Conference Proceedings Citation Index, Open Access Theses and Dissertations, and the five regional bibliographic databases of the World Health Organization until December 2020. Pooled odds ratios (OR) and their 95% confidence intervals (CI) were calculated according to the inverse of their variances. We performed separate analyses by histologic type. We also evaluated publication bias and assessed quality. A total of 17 study units met our inclusion criteria. The results show an association of hematologic malignancies with any paracetamol intake (OR 1.49, 95% CI 1.23-1.80) and with high paracetamol intake (OR 1.77, 95% CI 1.45-2.16). By subtype, risk was higher for multiple myeloma (OR 2.13, 95% CI 1.54-2.94) for any use and OR 3.16, 95% CI 1.96-5.10 for high intake, while risk was lower and non-significant for non-Hodgkin lymphoma. This meta-analysis provides evidence that paracetamol intake may be associated with hematologic malignancies and suggests that a dose-response effect is plausible. These results are unlikely to be due to publication bias or low quality of studies. Future research should focus on assessing the dose-response relationship.
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Affiliation(s)
- Jesús Prego-Domínguez
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-881-812268; Fax: +34-981-572282
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9
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Aspirin's Protective Effects Highlight the Role of Inflammation in UV-Induced Skin Damage and Carcinogenesis. J Invest Dermatol 2020; 141:10-11. [PMID: 33342505 DOI: 10.1016/j.jid.2020.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 11/24/2022]
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10
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Blakely KM, Drucker AM, Rosen CF. Drug-Induced Photosensitivity-An Update: Culprit Drugs, Prevention and Management. Drug Saf 2020; 42:827-847. [PMID: 30888626 DOI: 10.1007/s40264-019-00806-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Photosensitive drug eruptions are cutaneous adverse events due to exposure to a medication and either ultraviolet or visible radiation. In this review, the diagnosis, prevention and management of drug-induced photosensitivity is discussed. Diagnosis is based largely on the history of drug intake and the appearance of the eruption primarily affecting sun-exposed areas of the skin. This diagnosis can also be aided by tools such as phototesting, photopatch testing and rechallenge testing. The mainstay of management is prevention, including informing patients of the possibility of increased photosensitivity as well as the use of appropriate sun protective measures. Once a photosensitivity reaction has occurred, it may be necessary to discontinue the culprit medication and treat the reaction with corticosteroids. For certain medications, long-term surveillance may be indicated because of a higher risk of developing melanoma or squamous cell carcinoma at sites of earlier photosensitivity reactions. A large number of medications have been implicated as causes of photosensitivity, many with convincing clinical and scientific supporting evidence. We review the medical literature regarding the evidence for the culpability of each drug, including the results of phototesting, photopatch testing and rechallenge testing. Amiodarone, chlorpromazine, doxycycline, hydrochlorothiazide, nalidixic acid, naproxen, piroxicam, tetracycline, thioridazine, vemurafenib and voriconazole are among the most consistently implicated and warrant the most precaution by both the physician and patient.
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Affiliation(s)
- Kim M Blakely
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Cheryl F Rosen
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada. .,Division of Dermatology, Toronto Western Hospital, Toronto, ON, Canada.
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11
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Ma Y, Yu P, Lin S, Li Q, Fang Z, Huang Z. The association between nonsteroidal anti-inflammatory drugs and skin cancer: Different responses in American and European populations. Pharmacol Res 2019; 152:104499. [PMID: 31689521 DOI: 10.1016/j.phrs.2019.104499] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/02/2019] [Accepted: 10/15/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a comprehensive systematic meta-analysis investigating the association of nonsteroidal anti-inflammatory drugs (NSAIDs) and their subtypes with skin cancer (SC) and its subclasses (basal cell carcinoma BCC; squamous cell carcinoma SCC; melanoma; nonmelanoma skin cancer NMSC) in general, American and European populations. METHODS PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure and ClinicalTrials.gov were searched up to 24 February 2019. Pooled effect sizes and 95% confidence intervals were used to estimate associations. RESULTS Results based on 26 original studies including 223,619 cases and 1,398,507 controls showed both NSAIDs and nonselective Cyclooxygenase (COX) inhibitors to be statistically significantly associated with a reduced risk of SC, BCC, SCC and NMSC but not with melanoma. Conversely, no association was observed between selective Cyclooxygenase 2 (COX-2) inhibitors and SC or its subclasses. Further subgroup analysis showed that the results analyzed for American populations were almost the same as those for the general population. For European populations, neither NSAIDs nor its subtypes correlated significantly with susceptibility to SC or its subclasses. CONCLUSIONS The use of NSAIDs might reduce the risk of SC, but many factors including study population, drug subtype, and disease subclass affect the significance of the association.
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Affiliation(s)
- Yukun Ma
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Piaojian Yu
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Shuhuang Lin
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Qiqun Li
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Zijing Fang
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Zunnan Huang
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; Institute of Marine Biomedical Research, Guangdong Medical University, Zhanjiang, Guangdong 524023, China.
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12
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Rundle CW, Dellavalle RP. Nonsteroidal anti-inflammatory drug associations with nonmelanoma skin cancer - the saga continues. Br J Dermatol 2019; 181:654-656. [PMID: 31576570 DOI: 10.1111/bjd.18345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C W Rundle
- Department of Dermatology, University of Colorado School of Medicine, Denver, CO, U.S.A
| | - R P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Denver, CO, U.S.A.,Department of Public Health, University of Colorado School of Medicine, Denver, CO, U.S.A.,Chief, Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, U.S.A
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13
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Jeter JM, Bowles TL, Curiel-Lewandrowski C, Swetter SM, Filipp FV, Abdel-Malek ZA, Geskin LJ, Brewer JD, Arbiser JL, Gershenwald JE, Chu EY, Kirkwood JM, Box NF, Funchain P, Fisher DE, Kendra KL, Marghoob AA, Chen SC, Ming ME, Albertini MR, Vetto JT, Margolin KA, Pagoto SL, Hay JL, Grossman D, Ellis DL, Kashani-Sabet M, Mangold AR, Markovic SN, Meyskens FL, Nelson KC, Powers JG, Robinson JK, Sahni D, Sekulic A, Sondak VK, Wei ML, Zager JS, Dellavalle RP, Thompson JA, Weinstock MA, Leachman SA, Cassidy PB. Chemoprevention agents for melanoma: A path forward into phase 3 clinical trials. Cancer 2018; 125:18-44. [PMID: 30281145 DOI: 10.1002/cncr.31719] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/10/2018] [Accepted: 07/12/2018] [Indexed: 12/12/2022]
Abstract
Recent progress in the treatment of advanced melanoma has led to unprecedented improvements in overall survival and, as these new melanoma treatments have been developed and deployed in the clinic, much has been learned about the natural history of the disease. Now is the time to apply that knowledge toward the design and clinical evaluation of new chemoprevention agents. Melanoma chemoprevention has the potential to reduce dramatically both the morbidity and the high costs associated with treating patients who have metastatic disease. In this work, scientific and clinical melanoma experts from the national Melanoma Prevention Working Group, composed of National Cancer Trials Network investigators, discuss research aimed at discovering and developing (or repurposing) drugs and natural products for the prevention of melanoma and propose an updated pipeline for translating the most promising agents into the clinic. The mechanism of action, preclinical data, epidemiological evidence, and results from available clinical trials are discussed for each class of compounds. Selected keratinocyte carcinoma chemoprevention studies also are considered, and a rationale for their inclusion is presented. These data are summarized in a table that lists the type and level of evidence available for each class of agents. Also included in the discussion is an assessment of additional research necessary and the likelihood that a given compound may be a suitable candidate for a phase 3 clinical trial within the next 5 years.
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Affiliation(s)
- Joanne M Jeter
- Department of Medicine, Divisions of Genetics and Oncology, The Ohio State University, Columbus, Ohio
| | - Tawnya L Bowles
- Department of Surgery, Intermountain Health Care, Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah
| | | | - Susan M Swetter
- Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center Cancer Institute, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Fabian V Filipp
- Systems Biology and Cancer Metabolism, Program for Quantitative Systems Biology, University of California Merced, Merced, California
| | | | - Larisa J Geskin
- Department of Dermatology, Cutaneous Oncology Center, Columbia University Medical Center, New York, New York
| | - Jerry D Brewer
- Department of Dermatologic Surgery, Mayo Clinic Minnesota, Rochester, Minnesota
| | - Jack L Arbiser
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia
| | - Jeffrey E Gershenwald
- Departments of Surgical Oncology and Cancer Biology, Melanoma and Skin Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emily Y Chu
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - John M Kirkwood
- Melanoma and Skin Cancer Program, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Neil F Box
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - David E Fisher
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Kari L Kendra
- Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, Ohio
| | - Ashfaq A Marghoob
- Memorial Sloan Kettering Skin Cancer Center and Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Division of Dermatology, Veterans Affairs Medical Center, Atlanta, Georgia
| | - Michael E Ming
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark R Albertini
- Department of Medicine, University of Wisconsin, School of Medicine and Public Health, University of Wisconsin Carbone Cancer Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - John T Vetto
- Division of Surgical Oncology, Oregon Health & Science University, Portland, Oregon
| | - Kim A Margolin
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California
| | - Sherry L Pagoto
- Department of Allied Health Sciences, UConn Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, Connecticut
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Douglas Grossman
- Departments of Dermatology and Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Darrel L Ellis
- Department of Dermatology, Vanderbilt University Medical Center and Division of Dermatology, Vanderbilt Ingram Cancer Center, Nashville, Tennessee.,Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Affairs Medical Center, Nashville, Tennessee
| | - Mohammed Kashani-Sabet
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California
| | | | | | | | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - June K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Debjani Sahni
- Department of Dermatology, Boston Medical Center, Boston, Massachusetts
| | | | - Vernon K Sondak
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida.,Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Maria L Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, California.,Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Jonathan S Zager
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Dermatology Service, U.S. Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, Colorado.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John A Thompson
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Martin A Weinstock
- Center for Dermatoepidemiology, Veterans Affairs Medical Center, Providence, Rhode Island.,Department of Dermatology, Brown University, Providence, Rhode Island.,Department of Epidemiology, Brown University, Providence, Rhode Island.,Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island
| | - Sancy A Leachman
- Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Pamela B Cassidy
- Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
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14
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Malignant melanoma associated with chronic once-daily aspirin exposure in males: A large, single-center, urban, US patient population cohort study from the “Research on Adverse Drug events And Report” (RADAR) project. J Am Acad Dermatol 2018; 79:762-764. [DOI: 10.1016/j.jaad.2018.03.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 01/03/2023]
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15
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Qiao Y, Yang T, Gan Y, Li W, Wang C, Gong Y, Lu Z. Associations between aspirin use and the risk of cancers: a meta-analysis of observational studies. BMC Cancer 2018. [PMID: 29534696 PMCID: PMC5851082 DOI: 10.1186/s12885-018-4156-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Epidemiological studies have clarified the potential associations between regular aspirin use and cancers. However, it remains controversial on whether aspirin use decreases the risk of cancers risks. Therefore, we conducted an updated meta-analysis to assess the associations between aspirin use and cancers. Methods The PubMed, Embase, and Web of Science databases were systematically searched up to March 2017 to identify relevant studies. Relative risks (RRs) with 95% confidence intervals (CIs) were used to assess the strength of associations. Results A total of 218 studies with 309 reports were eligible for this meta-analysis. Aspirin use was associated with a significant decrease in the risk of overall cancer (RR = 0.89, 95% CI: 0.87–0.91), and gastric (RR = 0.75, 95% CI: 0.65–0.86), esophageal (RR = 0.75, 95% CI: 0.62–0.89), colorectal (RR = 0.79, 95% CI: 0.74–0.85), pancreatic (RR = 0.80, 95% CI: 0.68–0.93), ovarian (RR = 0.89, 95% CI: 0.83–0.95), endometrial (RR = 0.92, 95% CI: 0.85–0.99), breast (RR = 0.92, 95% CI: 0.88–0.96), and prostate (RR = 0.94, 95% CI: 0.90–0.99) cancers, as well as small intestine neuroendocrine tumors (RR = 0.17, 95% CI: 0.05–0.58). Conclusions These findings suggest that aspirin use is associated with a reduced risk of gastric, esophageal, colorectal, pancreatic, ovarian, endometrial, breast, and prostate cancers, and small intestine neuroendocrine tumors. Electronic supplementary material The online version of this article (10.1186/s12885-018-4156-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yan Qiao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Tingting Yang
- Department of Nutriology, The People's Hospital of Henan Province, Zhengzhou, Henan, 450003, People's Republic of China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
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16
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Chhabra G, Ndiaye MA, Garcia-Peterson LM, Ahmad N. Melanoma Chemoprevention: Current Status and Future Prospects. Photochem Photobiol 2017; 93:975-989. [PMID: 28295364 DOI: 10.1111/php.12749] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/02/2017] [Indexed: 12/11/2022]
Abstract
The incidence of skin cancers, both nonmelanoma and melanoma, is increasing in the United States. The ultraviolet radiation, mainly from sun, is considered the major cause for these neoplasms. While nonmelanoma skin cancers are far more numerous, melanoma remains the most challenging. This is because melanoma can become extremely aggressive and its incidence is increasing worldwide due to lack of effective early detection, as well as disease recurrence, following both surgery and chemotherapy. Therefore, in addition to better treatment options, newer means are required to prevent melanomas from developing. Chemoprevention is a reasonable cost-effective approach to prevent carcinogenesis by inhibiting the processes of tumor initiation, promotion and progression. Melanoma is a progressive disease, which makes it very suitable for chemopreventive interventions, by targeting the processes and molecular pathways involved in the progression of melanoma. This review discusses the roles of various chemopreventive agents such as NSAIDs, statins, vitamins and dietary agents in melanoma and highlights current advancements and our perspective on future of melanoma chemoprevention. Although considerable preclinical data suggest that melanoma may be prevented or delayed by a numerous chemopreventive agents, we realize there are insufficient clinical studies evaluating their efficacy and long-term safety for human use.
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Affiliation(s)
- Gagan Chhabra
- Department of Dermatology, University of Wisconsin, Madison, WI
| | - Mary Ann Ndiaye
- Department of Dermatology, University of Wisconsin, Madison, WI
| | | | - Nihal Ahmad
- Department of Dermatology, University of Wisconsin, Madison, WI.,William S. Middleton VA Medical Center, Madison, WI
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17
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Mounessa J, Buntinx-Krieg T, Qin R, Dunnick CA, Dellavalle RP. Primary and Secondary Chemoprevention of Malignant Melanoma. Am J Clin Dermatol 2016; 17:625-634. [PMID: 27665299 DOI: 10.1007/s40257-016-0221-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The incidence of malignant melanoma (MM) continues to rise in the United States. While sun protection and full body skin examinations remain the mainstay of preventative care, chemoprevention of the deadly disease has become an increasingly popular field of study. In this focused review, we discuss current findings and analyze the risks and benefits of various agents investigated for the primary and secondary chemoprevention of MM. Such agents include topical retinoids, vitamins, and supplements, Polypodium leucotomas extracts, non-steroidal anti-inflammatory agents (NSAIDs), statins, sunscreens, and field therapy with topical imiquimod for primary and secondary chemoprevention. We further identify a need for expanded high quality human research on the topic.
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Affiliation(s)
- Jessica Mounessa
- Stony Brook University School of Medicine, 101 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Dermatology, University of Colorado Hospital, 1665 Aurora Ct, Aurora, CO, 80045, USA
| | - Talayesa Buntinx-Krieg
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Rosie Qin
- Department of Medicine, University of San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado Hospital, 1665 Aurora Ct, Aurora, CO, 80045, USA
- Department of Dermatology, Denver VA Medical Center, 1055 Clermont St. #165, Denver, CO, 80220, USA
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Hospital, 1665 Aurora Ct, Aurora, CO, 80045, USA.
- Department of Dermatology, Denver VA Medical Center, 1055 Clermont St. #165, Denver, CO, 80220, USA.
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18
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Use of acetaminophen in relation to the occurrence of cancer: a review of epidemiologic studies. Cancer Causes Control 2016; 27:1411-1418. [PMID: 27832383 PMCID: PMC5108822 DOI: 10.1007/s10552-016-0818-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 10/20/2016] [Indexed: 11/24/2022]
Abstract
Acetaminophen has several pharmacologic properties that suggest it could be carcinogenic in human beings. A number of epidemiologic studies have been conducted to examine whether use of acetaminophen actually predisposes to the occurrence of one or more forms of cancer. There are inherent limitations to many of these studies, including the inaccurate identification of users and nonusers of acetaminophen, relatively short follow-up for cancer incidence, and the potential for confounding by indication. The present manuscript reviews the results of epidemiologic studies of acetaminophen use in relation to cancer incidence published through the end of 2015. The limitations of the underlying studies notwithstanding, some interim conclusions can be reached. For all but several forms of cancer, there is no suggestion that persons who have taken acetaminophen are at altered risk, even persons who have consumed a large quantity of the drug or those who have taken it for an extended duration. While in some studies the incidence of renal cell carcinoma has been observed to be increased among acetaminophen users, several other studies have failed to observe any such association; the reason for the discrepant findings is unclear. Some of the small number of studies that have presented data on the incidence of lymphoma, leukemia, and plasma cell disorders have found the risk to be modestly higher in users than nonusers of acetaminophen, but the results of other studies of these malignancies will be needed to gauge the possible role of publication bias as the basis for the positive results.
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19
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Muranushi C, Olsen CM, Green AC, Pandeya N. Can oral nonsteroidal antiinflammatory drugs play a role in the prevention of basal cell carcinoma? A systematic review and metaanalysis. J Am Acad Dermatol 2016; 74:108-119.e1. [DOI: 10.1016/j.jaad.2015.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/28/2015] [Accepted: 08/15/2015] [Indexed: 12/12/2022]
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20
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Khalesi M, Whiteman DC, Rosendahl C, Johns R, Hackett T, Cameron A, Waterhouse M, Lucas RM, Kimlin MG, Neale RE. Basal cell carcinomas on sun-protected vs. sun-exposed body sites: a comparison of phenotypic and environmental risk factors. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2015; 31:202-11. [PMID: 25787710 DOI: 10.1111/phpp.12170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in White populations. There are indications that risk factors for BCC may differ according to the anatomic site of the tumour but this is not well understood. PURPOSE To compare phenotypic and environmental risk factors for BCCs arising on sun-protected sites with that of those on sun-exposed sites. METHODS We conducted a case-case study in which people who had been diagnosed with incident BCC were recruited between February 2012 and September 2013 in Brisbane, Australia. RESULTS Fair skin (OR: 4.50; 95% CI: 1.22, 16.59), having more than 15 lesions frozen/burnt off compared to less than 5 (OR: 5.68; 95% CI: 1.78, 18.08) and severe acne (OR: 5.25; 95% CI: 1.34, 20.56) were associated with increased risk of BCC on sun-protected sites. The presence of more than 5 nevi on the body was associated with decreased risk (OR: 0.28; 95% CI: 0.11, 0.71). CONCLUSIONS BCCs on sun-protected sites arise as a result of excessive sun exposure, most likely combined with phenotypic susceptibility. The strong negative association with nevi also suggests that there are constitutional factors that underlie the propensity for BCCs to arise on these body sites.
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Affiliation(s)
- Mohammad Khalesi
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Cliff Rosendahl
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Richard Johns
- Skin Cancer College Australasia, Brisbane, QLD, Australia
| | - Timothy Hackett
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Alan Cameron
- Skin Cancer College Australasia, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Mary Waterhouse
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Michael G Kimlin
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Brisbane, QLD, Australia
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21
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Aspirin and Nonsteroidal Anti-Inflammatory Drugs Can Prevent Cutaneous Squamous Cell Carcinoma: a Systematic Review and Meta-Analysis. J Invest Dermatol 2015; 135:975-983. [DOI: 10.1038/jid.2014.531] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/09/2014] [Accepted: 09/15/2014] [Indexed: 11/08/2022]
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22
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ZHU YUN, CHENG YANG, LUO RONGCHENG, LI AIMIN. Aspirin for the primary prevention of skin cancer: A meta-analysis. Oncol Lett 2015; 9:1073-1080. [PMID: 25663859 PMCID: PMC4314970 DOI: 10.3892/ol.2015.2853] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 12/08/2014] [Indexed: 01/17/2023] Open
Abstract
Skin cancer is one of the most common cancers worldwide. There are three major skin cancer types: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. General risk factors for skin cancer include fair skin, a history of tanning and sunburn, family history of skin cancer, exposure to ultraviolet rays and a large number of moles. The incidence of skin cancer has increased in the USA in recent years. Aspirin intake is associated with chemoprotection against the development of a number of types of cancer. However, whether aspirin intake can reduce the risk of development of skin cancer is unclear. The present meta-analysis of available human studies is aimed at evaluating the association between aspirin exposure and the risk of skin cancer. All available human observational studies on aspirin intake for the primary prevention of skin cancer were identified by searching MEDLINE (Pubmed), BIOSIS, EMBASE, Cochrane Library and China National Knowledge Infrastructure prior to March 2013. The heterogeneity and publication bias of all studies were evaluated using Cochran's Q and I2 statistics, followed by a random-effect model where applicable. The pooled data were analyzed by odds ratios (ORs) and 95% confidence intervals (CIs). A total of eight case-control and five prospective cohort studies from 11 publications were selected for this analysis. There was no evidence of publication bias in these studies. Statistical analyses of the pooled data demonstrated that that a daily dose of 50-400 mg aspirin was significantly associated with a reduced risk of skin cancers (OR, 0.94; 95% CI, 0.90-0.99; P=0.02). Stratification analysis indicated that the continual intake of low dose aspirin (≤150 mg) reduced the risk of developing skin cancer (OR, 0.95; CI, 0.90-0.99; P=0.15) and that aspirin intake was significantly associated with a reduced risk of non-melanoma skin cancers (OR, 0.97; CI, 0.95-0.99; P=0.22). Overall, these findings indicated that aspirin intake was associated with a reduced risk of developing skin cancer. However, more well-designed randomized controlled trials to measure the effects of aspirin intake are required to confirm this.
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Affiliation(s)
- YUN ZHU
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - YANG CHENG
- Digestive Department of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - RONG-CHENG LUO
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong 510315, P.R. China
- Correspondence to: Dr Rong-Cheng Luo and Dr Ai-Min Li, Cancer Center, Southern Medical University, 1838 North Guangzhou Road, Guangzhou, Guangdong 510515, P.R. China, E-mail: , E-mail:
| | - AI-MIN LI
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong 510315, P.R. China
- Correspondence to: Dr Rong-Cheng Luo and Dr Ai-Min Li, Cancer Center, Southern Medical University, 1838 North Guangzhou Road, Guangzhou, Guangdong 510515, P.R. China, E-mail: , E-mail:
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Wysong A, Ally MS, Gamba CS, Desai M, Swetter SM, Seiffert-Sinha K, Sinha AA, Stefanick ML, Tang JY. Non-melanoma skin cancer and NSAID use in women with a history of skin cancer in the Women's Health Initiative. Prev Med 2014; 69:8-12. [PMID: 25150382 DOI: 10.1016/j.ypmed.2014.08.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/28/2014] [Accepted: 08/12/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Evidence for the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on non-melanoma skin cancer (NMSC) risk is inconsistent. We prospectively examined whether regular, inconsistent, or no/low-use of NSAIDs is associated with lower NMSC risk among 54,728 postmenopausal Caucasian women in the Women's Health Initiative Observational Study enrolled between 1993 and 1998. METHODS Logistic regression models were used to assess odds of NMSC after adjusting for skin type, sun exposure history and indication for NSAID use. RESULTS There were 7652 incident cases of NMSC (median follow-up: 6.9years). There was no association between regular NSAID-use and NMSC risk relative to no/low-users. However, in a subgroup analysis of 5325 women with a history of skin cancer (incident NMSC: 1897), odds of NMSC were lower among regular NSAID users whether <5years (OR 0.82, 95% CI: 0.70-0.95) or ≥5years (OR 0.82, 95% CI: 0.69-0.98) of use compared to no/low-users. Inconsistent NSAID use and acetaminophen use were not associated with NMSC risk. CONCLUSION Overall, NSAID use was not associated with NMSC risk. However, in women with a history of skin cancer, regular NSAID use was associated with 18% lower odds of NMSC. Future studies on potential chemopreventative effects of NSAIDs should focus on subjects with prior history of NMSC.
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Affiliation(s)
- Ashley Wysong
- University of Southern California, Keck School of Medicine, Department of Dermatology, Los Angeles, CA, United States; Stanford University, Department of Dermatology, Redwood City, CA, United States.
| | - Mina S Ally
- Stanford University, Department of Dermatology, Redwood City, CA, United States
| | - Christina S Gamba
- Stanford University School of Medicine and Cancer Institute, Stanford, CA, United States
| | - Manisha Desai
- Stanford University School of Medicine and Cancer Institute, Stanford, CA, United States
| | - Susan M Swetter
- Stanford University, Department of Dermatology, Redwood City, CA, United States; Stanford University School of Medicine and Cancer Institute, Stanford, CA, United States; VA Palo Alto Health Care System, Palo Alto, CA, United States
| | | | - Animesh A Sinha
- Department of Dermatology, University at Buffalo, Buffalo, NY, United States
| | - Marcia L Stefanick
- Stanford University School of Medicine and Cancer Institute, Stanford, CA, United States
| | - Jean Y Tang
- Stanford University, Department of Dermatology, Redwood City, CA, United States; Stanford University School of Medicine and Cancer Institute, Stanford, CA, United States
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24
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Schneider SL, Ross AL, Grichnik JM. Do inflammatory pathways drive melanomagenesis? Exp Dermatol 2014; 24:86-90. [PMID: 25041143 DOI: 10.1111/exd.12502] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2014] [Indexed: 12/12/2022]
Abstract
Inflammatory pathways serve to protect the host and promote tissue healing/repair; however, over-activation or dysregulation can be pathological with unintended consequences including malignant progression. A correlation between inflammation and cancer has been well established, and anti-inflammatory medications have been shown to be chemopreventive in certain malignancies. Data are now becoming available that outline an inflammatory pathway that may have a critical role in melanomagenesis. ATP-regulated membrane channels/receptors P2X7 and PANX1 have been directly implicated in melanoma tumor growth. Among other potential effects, opening of the P2X7/PANX1 channel results in activation of the NALP3 inflammasome, which in turn leads to caspase-1 activation and increased levels of activated IL-1β. Elevated levels of caspase-1 and IL-1β have been correlated with melanoma progression, and inhibitors of the inflammasome, caspase and IL-1β activity have all been shown to inhibit melanoma growth. Among many other potential actions, IL-1β increases cyclooxygenase-2 expression leading to local increases in inflammatory mediators such as prostaglandin E2 (PGE2). Anti-inflammatory medications targeting the end of this pathway have had positive results for certain cancers but overall remain mixed for melanoma. A better understanding of the pathways and appropriate intervention points may help direct future therapies. In this viewpoint, we will review data and attempt to model an inflammatory pathway that may be critical for melanomagenesis and propose future directions for exploration.
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Affiliation(s)
- Samantha L Schneider
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA; Albert Einstein College of Medicine, Bronx, NY, USA
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25
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Zhang B, Liang X, Ye L, Wang Y. No chemopreventive effect of nonsteroidal anti-inflammatory drugs on nonmelanoma skin cancer: evidence from meta-analysis. PLoS One 2014; 9:e96887. [PMID: 24828489 PMCID: PMC4020781 DOI: 10.1371/journal.pone.0096887] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/12/2014] [Indexed: 12/17/2022] Open
Abstract
Background Nonmelanoma skin cancer (NMSC),which includes squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is the most common form of cancer, and its incidence is increasing. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to be chemopreventive for NMSC. However, the results from published studies were controversial. Methods We searched the PubMed and Embase databases for relevant studies. Moreover, relevant reviews regarding the use of NSAIDs for NMSC patients were examined for potential inclusive studies. To measure the effects of NSAIDs, the relative risk (RR) was analyzed. Results A Total of 8 studies were included in our meta-analysis. We found that NSAIDs use was not associated with a reduced risk of SCC or BCC under the random effects model (pooled RR = 0.86, 95% CI, 0.73–1.02, P = 0.085; pooled RR = 0.94, 95% CI 0.85–1.04, P = 0.266; respectively). Conclusion From the included studies, we found no statistically significant chemopreventive effect on NMSC of NSAIDs. This finding warrants more prospective studies evaluating the relationship between NSAIDs and NMSC.
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Affiliation(s)
- Bo Zhang
- Training Division, Third Military Medical Universality, Chongqing, China
- Department of medical administration, General Hospital of Beijing Military Command, Beijing, China
- * E-mail: (YW); (BZ)
| | - Xiaolu Liang
- Department of Ultrasonography, General Hospital of Beijing Military Command, Beijing, China
| | - Liaosha Ye
- Department of medical administration, General Hospital of Beijing Military Command, Beijing, China
| | - Yungui Wang
- Training Division, Third Military Medical Universality, Chongqing, China
- * E-mail: (YW); (BZ)
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26
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Goodman JR, Grossman D. Aspirin and other NSAIDs as chemoprevention agents in melanoma. Cancer Prev Res (Phila) 2014; 7:557-64. [PMID: 24694780 DOI: 10.1158/1940-6207.capr-14-0018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Melanoma incidence is increasing and, despite recent therapeutic advances, the prognosis for patients with metastatic disease remains poor. Thus, early detection and chemoprevention are promising strategies for improving patient outcomes. Aspirin (acetylsalicylic acid) and other nonsteroidal anti-inflammatory drugs (NSAID) have demonstrated chemoprotective activity in several other cancers, and have been proposed as chemopreventive agents for melanoma. Throughout the last decade, however, a number of case-control, prospective, and interventional studies of NSAIDs and melanoma risk have yielded conflicting results. These inconsistent findings have led to uncertainty about the clinical utility of NSAIDs for melanoma chemoprevention. This mini-review highlights current knowledge of NSAID mechanisms of action and rationale for use in melanoma, provides a comparative review of outcomes and limitations of prior studies, and discusses the future challenges in demonstrating that these drugs are effective agents for mitigating melanoma risk.
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Affiliation(s)
- James R Goodman
- Authors' Affiliations: Huntsman Cancer Institute; Departments of Dermatology and Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Douglas Grossman
- Authors' Affiliations: Huntsman Cancer Institute; Departments of Dermatology and Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, UtahAuthors' Affiliations: Huntsman Cancer Institute; Departments of Dermatology and Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, UtahAuthors' Affiliations: Huntsman Cancer Institute; Departments of Dermatology and Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah
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27
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Aspirin use and melanoma risk: A review of the literature. J Am Acad Dermatol 2014; 70:187-91. [DOI: 10.1016/j.jaad.2013.09.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 09/20/2013] [Accepted: 09/21/2013] [Indexed: 01/04/2023]
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28
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Hollestein LM, van Herk-Sukel MPP, Ruiter R, de Vries E, Mathijssen RHJ, Wiemer EAC, Stijnen T, Coebergh JWW, Lemmens VEPP, Herings RMC, Stricker BHC, Nijsten T. Incident cancer risk after the start of aspirin use: results from a Dutch population-based cohort study of low dose aspirin users. Int J Cancer 2013; 135:157-65. [PMID: 24285345 DOI: 10.1002/ijc.28634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 12/18/2022]
Abstract
Observational and intervention studies suggest that low dose aspirin use may prevent cancer. The objective of this study was to investigate the protective effect of long term low dose aspirin use (≤100 mg daily) on cancer in general and site-specific cancer among low dose aspirin users in the Dutch general population. We conducted a population-based cohort study with detailed information on aspirin exposure and cancer incidence. Only incident (new) low dose aspirin users, who were included in the linkage between PHARMO and the Eindhoven Cancer Registry (1998-2010) and free of cancer before the start of follow up were included. A Cox proportional hazard model with cumulative aspirin use as a time-varying determinant was used to obtain hazard ratios (HR). Duration of aspirin use amongst 109,276 incident low dose aspirin users was not associated with a decreased risk of any of the site-specific cancers or cancer in general (adjusted HR per year of aspirin use for all cancers: 1.02, 95% confidence interval [CI] 1.00-1.04, HR of >6 years aspirin use compared to <2 years: 1.17, 95% CI 1.02-1.34). After adjusting for current and past aspirin use, 2-6 years of low dose aspirin use was associated with a reduced colorectal cancer risk compared to <2 years of aspirin use (adjusted HR 0.75, 95% CI 0.59-0.96). However, a clear dose-response relationship was not observed (adjusted HR >6 years aspirin use 0.95, 95% CI 0.60-1.49). Our results do not support the primary prevention of cancer among long term aspirin users.
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Affiliation(s)
- Loes M Hollestein
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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29
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Mikulec C, Rundhaug JE, Simper MS, Lubet RA, Fischer SM. The chemopreventive efficacies of nonsteroidal anti-inflammatory drugs: the relationship of short-term biomarkers to long-term skin tumor outcome. Cancer Prev Res (Phila) 2013; 6:675-85. [PMID: 23682071 PMCID: PMC3701752 DOI: 10.1158/1940-6207.capr-13-0064] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The ultraviolet B (UVB) component of sunlight, which causes DNA damage and inflammation, is the major cause of nonmelanoma skin cancer (NMSC), the most prevalent of all cancers. Nonsteroidal anti-inflammatory drugs (NSAID) and coxibs have been shown to be effective chemoprevention agents in multiple preclinical trials, including NMSC, colon, and urinary bladder cancer. NSAIDs, however, cause gastrointestinal irritation, which led to the recent development of nitric oxide (NO) derivatives that may partially ameliorate this toxicity. This study compared the efficacy of several NSAIDs and NO-NSAIDs on UV-induced NMSC in SKH-1 hairless mice and determined whether various short-term biomarkers were predictive of long-term tumor outcome with these agents. Naproxen at 100 (P = 0.05) and 400 ppm (P < 0.01) in the diet reduced tumor multiplicity by 26% and 63%, respectively. The NO-naproxen at slightly lower molar doses shows similar activities. Aspirin at 60 or 750 ppm in the diet reduced tumor multiplicity by 19% and 50%, whereas the equivalent doses (108 and 1,350 ppm) were slightly less effective. Sulindac at 25 and 150 ppm in the diet, doses far below the human equivalent dose was the most potent NSAID with reductions of 50% and 94%, respectively. In testing short-term biomarkers, we found that agents that reduce UV-induced prostaglandin E2 synthesis and/or inhibit UV-induced keratinocyte proliferation yielded long-term tumor efficacy.
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Affiliation(s)
- Carol Mikulec
- The Department of Molecular Carcinogenesis Science Park The University of Texas MD Anderson Cancer Center Smithville, TX 78957
| | - Joyce E. Rundhaug
- The Department of Molecular Carcinogenesis Science Park The University of Texas MD Anderson Cancer Center Smithville, TX 78957
| | - Melissa S. Simper
- The Department of Molecular Carcinogenesis Science Park The University of Texas MD Anderson Cancer Center Smithville, TX 78957
| | - Ronald A. Lubet
- Chemopreventive Agent Development Research Group Division of Cancer Prevention NIH Bethesda, MD 20852
| | - Susan M. Fischer
- The Department of Molecular Carcinogenesis Science Park The University of Texas MD Anderson Cancer Center Smithville, TX 78957
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30
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Ally MS, Swetter SM, Tang JY. Role of aspirin and non-aspirin NSAIDs in preventing melanoma. Future Oncol 2013; 9:1671-4. [PMID: 23731359 DOI: 10.2217/fon.13.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Mina S Ally
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C, MC 5334, Redwood City, CA, USA
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31
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Siiskonen SJ, Koomen ER, Visser LE, Herings RMC, Guchelaar HJ, Stricker BHC, Nijsten TEC. Exposure to phototoxic NSAIDs and quinolones is associated with an increased risk of melanoma. Eur J Clin Pharmacol 2013; 69:1437-44. [PMID: 23471440 DOI: 10.1007/s00228-013-1476-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/27/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Ultraviolet radiation exposure is the most important exogenous risk factor for cutaneous malignancies. It is possible that phototoxic drugs promote the development of cutaneous melanoma (CM) by intensifying the effect of ultraviolet light on the skin. We investigated the association between the use of common systemic phototoxic drugs and development of CM. METHODS This study was a case-control study in a Dutch population-based cohort. The drug dispensing data was obtained from PHARMO, a Dutch drug dispensing and hospital admissions registry, and linked to PALGA, the nationwide pathology network of the Netherlands. The cases were patients diagnosed with pathologically confirmed primary CM between 1991 and 2004. Controls were sampled from the PHARMO population. Exposure to systemic phototoxic drugs was measured and included antimicrobial agents, diuretics, antipsychotic drugs, antidiabetic drugs, cardiac drugs, antimalarials and nonsteroidal anti-inflammatory drugs (NSAIDs). A multivariate conditional logistic regression analysis was performed to study the association between exposure to phototoxic drugs and CM. RESULTS The study population included 1,318 cases and 6,786 controls. Any phototoxic drug during the study period was dispensed for 46 % of the cases and 43 % of the controls (p = 0.012). The use of quinolones [odds ratio (OR) 1.33, 95 % confidence interval (CI) 1.01-1.76] and propionic acid derivative NSAIDs (OR 1.33, 95 % CI 1.14-1.54) had a positive association with CM. CONCLUSIONS Our study shows that the use of phototoxic drugs is associated with an increased risk of developing CM. Even a short-term use of phototoxic quinolones and propionic acid derivative NSAIDs may increase the risk for CM. Patient education to promote sun-protective behaviour is essential to avoid immediate adverse effects and possible long-term effects of phototoxic drugs.
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Affiliation(s)
- Satu J Siiskonen
- Department of Dermatology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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32
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Burns EM, Tober KL, Riggenbach JA, Schick JS, Lamping KN, Kusewitt DF, Young GS, Oberyszyn TM. Preventative topical diclofenac treatment differentially decreases tumor burden in male and female Skh-1 mice in a model of UVB-induced cutaneous squamous cell carcinoma. Carcinogenesis 2012; 34:370-7. [PMID: 23125227 DOI: 10.1093/carcin/bgs349] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ultraviolet B (UVB) light is the major environmental carcinogen contributing to non-melanoma skin cancer (NMSC) development. There are over 3.5 million NMSC diagnoses in two million patients annually, with men having a 3-fold greater incidence of squamous cell carcinoma (SCC) compared with women. Chronic inflammation has been linked to tumorigenesis, with a key role for the cyclooxygenase-2 (COX-2) enzyme. Diclofenac, a COX-2 inhibitor and non-steroidal anti-inflammatory drug, currently is prescribed to patients as a short-term therapeutic agent to induce SCC precursor lesion regression. However, its efficacy as a preventative agent in patients without evidence of precursor lesions but with significant UVB-induced cutaneous damage has not been explored. We previously demonstrated in a murine model of UVB-induced skin carcinogenesis that when exposed to equivalent UVB doses, male mice had lower levels of inflammation but developed increased tumor multiplicity, burden and grade compared with female mice. Because of the discrepancy in the degree of inflammation between male and female skin, we sought to determine if topical treatment of previously damaged skin with an anti-inflammatory COX-2 inhibitor would decrease tumor burden and if it would be equally effective in the sexes. Our results demonstrated that despite observed sex differences in the inflammatory response, prolonged topical diclofenac treatment of chronically UVB-damaged skin effectively reduced tumor multiplicity in both sexes. Unexpectedly, tumor burden was significantly decreased only in male mice. Our data suggest a new therapeutic use for currently available topical diclofenac as a preventative intervention for patients predisposed to cutaneous SCC development before lesions appear.
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Affiliation(s)
- Erin M Burns
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
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