Sunday, January 21, 2018

Aspirin, NSAID's, and melanoma

I first posted on this bunch of mess in 2012!!!!  (I'm getting old and in melanoma land ~ or any other land, really ~ that is AWESOME!!!!)   Here's a link to a complete re-cap:  Sooo....advil works for SOME melanoma patients?????  As you can see from these posts:  Aspirin and other NSAID's decrease rates of melanoma!!  Well, maybe!!!  Advil and such make immunotherapy work better in treating melanoma.  Oh, perhaps not....or just for certain peeps! 
Hmmmm......  Now, there's this....

Post-diagnosis aspirin use and overall survival in patients with melanoma.  Wallace, Li, et al.  J Am Acad Dermatol. 2018 Jan 6.   

Mouse studies show that tumor-derived prostaglandins and platelets promote melanoma progression and immune-evasion. [To] Determine if aspirin confers longer survival in patients with melanoma - A retrospective cohort study of 1,522 patients at Indiana University Health (IUH) diagnosed with melanoma between 2000 and 2014 and followed up through September, 2016.

Aspirin use was associated with longer overall survival in univariate analysis and after controlling for age, sex, stage, and treatment modalities. Aspirin use was not associated with survival in patients with in situ and stage I melanoma, but was associated with better survival in stages II and III. No statistical significance was observed in stage IV patients. In turn, patients using aspirin before diagnosis were less likely to be diagnosed in stages III or IV disease. Observational study. Aspirin could provide a survival advantage in melanoma. Clinical trials investigating the therapeutic potential of aspirin are warranted.

In this study, researchers in Indiana reviewed the files of 1,522 melanoma patients diagnosed at their university between 2000 and 2014 and followed them through September of 2016.  Aspirin use was NOT associated with survival in patients with Stage I and in situ melanoma.  However, aspirin WAS associated with better survival for Stage II and III patients, while no statistical difference was found in Stage IV patients.  However, patients who used aspirin BEFORE they were diagnosed were found less like to "be diagnosed in Stages III or IV disease"

Hmmm.....You gotta love it when a new study only adds more confusion (or is that confirmation?????) to a yes/no situation!!!  Oh, well.  Melanoma provides no easy answers.  Low dose aspirin daily rarely hurts and helps some in a variety of ways.  Not something I've every partaken in....though advil has been an almost daily drug since taking anti-PD-1 for 2 1/2 years.  I think you'd be hard pressed to find immunotherapy patients who haven't been simultaneously "contaminated with" NSAID use, given the aches and pains the treatment produces.  Anyhow....still not sure what all this really means...if anything.  Be sure to talk to your doc about all your over the counter medicines and before starting a legit ASA regimen!  For what it's worth..... - c

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