Beware of Non-Aspirin NSAIDs for Kidney Cancer Patients

SAN FRANCISCO—Long-term use of non-steroidal Kidney Cancer Patients anti-inflammatory drugs (NSAIDs) appear to be associated with fatal cases of renal cell carcinoma, researchers cautioned here at the 2016 Genitourinary Cancers Symposium (Abstract 588).

“Prospective data suggest that non-aspirin NSAID use is associated with an increased incidence of fatal renal cell carcinoma after at least four years of use,” he and colleagues reported.“It is not entirely clear why there would be a difference in outcome between the NSAIDs and aspirin,” Preston told OT at his poster presentation. “One theory is that there may be some kind of interplay between prostaglandins, which causes chronic kidney injury, changes in DNA, and increased carcinogenesis.”“We think that the NSAIDs cause some kind of impact to the kidney itself,” he said, noting that in other cancers there did not seem to be a difference between NSAIDs and aspirin.

Study Statistics

In the pooled multivariate analysis, the risk of fatal renal cell carcinoma among people who take aspirin regularly does not appear to budge over the course of 10 years or more. But that is not the case with the NSAIDs, Preston said.There is no increase in fatal renal cell carcinoma at the four-year mark, but in the four to 10-year period, the risk rises significantly (relative risk 1.91 [95% CI: 1.04-3.49]). And among persons taking NSAIDs for more than 10 years, the risk is even greater (RR 3.97 [95% CI: 1.46-10.93]). Regular use of the analgesics was defined as taking the pills two or more times a week.

Preston and his colleagues examined the outcomes data in two large prospective cohorts: The Nurses’ Health Study (1990) and the Health Professionals Follow-up Study (1986). Information was collected from the participants every two years.

‘Compelling’ Results

Xinhua Zhu, MD, Attending Physician in Genitourinary Medical Oncology at Northwell Health Cancer Center in Lake Success, New York, told OT that he found the results compelling. “This evidence could be practice changing, not only for oncologists, but for primary care physicians as well.“In particular, the patients who have been exposed to non-aspirin NSAIDs for over 10 years should be counseled to discontinue this type of analgesics given the strong association between the use and the risk of developing renal cell cancer,” he said.

Preston said that when the researchers checked outcomes in patients diagnosed with clear cell kidney cancer, seen in 330 cases, the results with similar to the findings for the entire group.

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