Israeli researchers said they may have found a way to reduce the risk of post-surgical cancer recurrence through the use of a drug regimen that includes the combination of two drugs that relieve stress and inflammation and have been on the market for years.
Most cancer-related deaths are the result of the regrowth of cancer cells after surgery, a so-called post-surgical metastatic recurrence. In metastasis, cells of primary tumors travel to other parts of the body, where they often proliferate into inoperable, ultimately fatal growths.
Now, researchers at Tel Aviv University in collaboration with the University of California at Los Angeles and three Israeli hospitals say they have found a specific drug regimen that, administered to patients before and after surgery, “significantly reduces the risk of post-surgical cancer recurrence.”
The medications are a combination of a beta blocker, which relieves stress and high blood pressure, and an anti-inflammatory drug. The treatment is safe and inexpensive. The two medications are similar in price to aspirin, and are easily administered to patients without contraindications, the researchers said in a statement. The study was published in Clinical Cancer Research.
“We checked the molecular traits of the excised tumor and found that the drug treatment we administered makes the tumor less metastatic,” said Prof. Shamgar Ben-Eliyahu of TAU’s School of Psychological Sciences and Sagol School of Neuroscience. “What we don’t know yet is whether this improvement will be translated in lower cancer recurrence and lower mortality rates. A bigger study on this needs to be done and we will need funding for this.”
Taking an untrodden path
In their study the researchers deviated from the current medical procedure for cancer patients, which refrains from giving any treatment to patients during the short period surrounding a cancer surgery, which calls for no chemo-, radio- or immune therapy for at least three weeks before or after an operation, Ben-Eliyahu explained.
“We’ve taken an unconventional approach, deviating from the current medical dogma,” he said. “Even within the medical establishment, we encountered some levels of disbelief and antagonism. But after conducting ample studies in animal models of cancer, and reviewing the medical literature, we came to the firm conclusion that maybe this is the most important period in the prevention of cancer recurrence.”
For the study, 38 breast cancer patients at Sheba Medical Center, Kaplan Medical Center and Rabin Medical Center were given a pharmacological treatment — Deralin (used to reduce blood pressure and anxiety) and Etopan (used to reduce inflammation) — five days before their surgeries, the day of their surgeries and five days after their surgeries.
Blood and tumor tissue samples were then analyzed.
“We found that the drugs were very efficient in reducing biomarkers of metastatic processes,” Ben-Eliyahu said. “For example, we found that the drug treatment reverses EMT — the process that tumor cells go through to slip out of the primary tumor and enter another organ. It is a crucially important step in the metastatic process. We also looked at indices related to the immune system and were able to improve immune competence and reduce inflammation with the drugs.”
The research team conducted a similar, as-yet-unpublished study on colorectal cancer patients and found similar results, the university said in a statement.
The findings are the result of 20 years of studying animal models to see how surgery and psychological and physiological stress and inflammation cause the recurrence of cancer, Ben-Eliyahu said.
The researchers are currently considering a larger-scale clinical trial to establish the long-term beneficial effects of this treatment. But because the drugs used are generic medications and not protected by patents, big pharma firms may not be interesting in pursuing such research, he said.
“So we will need to be creative and find other ways,” he said.
The research was led by Ben-Eliyahu in collaboration with Prof. Steven Cole of UCLA; Prof. Oded Zmora of Sheba Medical Center, Tel Hashomer; Prof. Eran Sharon of Rabin Medical Center, Beilinson; and Prof. Tanir Ellweiss of Kaplan Medical Center.