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Asian Journal of Biomedical and Pharmaceutical Sciences | Volume 8
May 14-15, 2018 | Montreal, Canada
Global Summit on
Biopharma & Biotherapeutics
A
bimodal pattern of hazard of relapse among early stage
breast cancer patients has been identified in multiple
databases from US, Europe and Asia. My colleagues and I have
been studying these data to determine if this can lead to new
ideasonhowtopreventrelapseinbreastcancer.Usingcomputer
simulation and access to a very high-quality database from
Milan for patients treated with mastectomy only, we proposed
that relapses within three years of surgery are stimulated
somehow by the surgical procedure. Most relapses in breast
cancer are in this early category. Retrospective data from a
Brussels anesthesiology group suggests a plausible mechanism.
Use of ketorolac, a common NSAID analgesic used in surgery
was associated with far superior disease-free survival in the first
five years after surgery. The expected prominent early relapse
events in months 9-18 are reduced five-fold. Transient systemic
inflammationaccompanyingsurgery (identifiedby IL-6 inserum)
could facilitate angiogenesis of dormant micrometastases,
proliferation of dormant single cells, and seeding of circulating
cancer stem cells resulting in early relapse and could have been
effectively blocked by the perioperative anti-inflammatory
agent. If this observation holds up to further scrutiny, it could
mean that the simple use of this safe, inexpensive and effective
anti-inflammatory agent at surgery might eliminate early
relapses. We suggest this would be most effective for triple
negative breast cancer and be especially valuable in low and
middle income countries. Similar bimodal patterns have been
identified in other cancers suggesting a general effect. Even if
this project works as well as possible, it will not solve the breast
cancer problem. We think it will reduce relapse andmortality by
25 to 50% at low cost and toxicity but there will still be a need
for treatments to prevent death from metastatic disease. We
encourage the excellent work underway to use immunotherapy
to curtail tumor growth after relapse..
Speaker Biography
Michael W Retsky has completed his PhD in Physics from University of Chicago and
made a career change to cancer research 30 years ago. He was on Judah Folkman’s
Staff at Harvard Medical School for 12 years. He is Editor and Romano Demicheli is
Co-Editor of a Springer/Nature book on breast cancer published in July 2017. He is the
Founder and on the Board of Directors of the Colon Cancer Alliance and has published
more than 60 papers in physics and Cancer.
e:
michael.retsky@gmail.comMichael W Retsky
University College London, UK
Perioperative use of NSAID might prevent early relapses in breast and other cancers