Common NSAID found to improve ovarian cancer survival

By John Murphy, MDLinx
Published January 5, 2016

Key Takeaways

Researchers have found that ketorolac—a non-steroidal anti-inflammatory drug (NSAID) already FDA approved for acute pain—has an unknown benefit: it can help women with ovarian cancer survive longer.

In this retrospective study, scientists at the University of New Mexico Cancer Center in Albuquerque, NM, examined the medical records of 123 women who had undergone ovarian cancer surgery between 2004 and 2006. They found that women who had received ketorolac to ease their postoperative pain were 30% more likely to have survived their cancer after 5 years. The results were published online in Clinical Cancer Research.

Ovarian cancer is the leading cause of death from gynecologic malignancies and the second most common gynecologic cancer. Five-year patient survival remains less than 50%, and the mortality rate hasn’t changed much in 20 years. Despite concerted efforts, investigators have found no effective targeted therapies, the authors wrote in their study.

Ketorolac, marketed as Toradol, is administered intravenously as an equal, racemic mixture of S-ketorolac and R-ketorolac. The racemic composition means that R- and S-ketorolac have the same chemical formula but, like right and left hands, they are mirror images of each other in three dimensions. The S-form provides the analgesic activity.

In this study, subjects who received ketorolac were given a single IV dose within the first 72 hours of ovarian cancer surgery. The researchers found that when ketorolac is injected into the bloodstream, the body removes S-ketorolac more rapidly and allows R-ketorolac to move to and gather in the peritoneal cavity, where ovarian cancer starts and grows. In gathering here, the R-ketorolac appears to inhibit GTPases, proteins known to increase the tumor cells’ ability to grow and spread.

“After adjusting for age, AJCC [American Joint Committee on Cancer] stage, completion of chemotherapy, and neo-adjuvant therapy, women given peri-operative ketorolac had a lower hazard of death,” the authors concluded. “Collectively, our findings support the potential repositioning of ketorolac as an addition to current ovarian cancer therapy.”

The scientists are now developing placebo-controlled human clinical trials to better understand how ketorolac works in women after ovarian cancer surgery.

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