Understanding the Interplay of Aspirin and Other Commonly Used Medication and the Potential for Ovarian Cancer Chemoprevention
Abstract
Rationale and Objective: Ovarian cancer is the most fatal cancer affecting women, largely due to the symptoms of the disease, like pain and pressure, being common and therefore leading to delays in diagnosis. Currently, there are no tests to detect early-stage ovarian cancer and very limited ways to prevent it. While women with higher risk of the disease because of genetic mutations in the BRCA1 or BRCA2 genes can have surgery to remove their ovaries, the disadvantages are that the surgery leads to infertility and early menopause and may not be acceptable to all who are eligible. Traditional cancer risk factors, like physical activity, body mass index, and diet are not associated with large increases in ovarian cancer risk. Oral contraceptive use for five years or longer can prevent ovarian cancer, but it is not suitable as a recommendation for all women due to harmful side effects in certain individuals (e.g., risk of venous thromboembolism in smokers) and undesirable side effects like weight gain. Thus, there is a great need to find prevention strategies to reduce the number of women being diagnosed with ovarian cancer. Further, given that all medications come with some risk of side effects, it is important to identify subgroups that will benefit most from ovarian cancer chemoprevention—the prevention of disease through medication use. The subgroups that will likely derive the most benefit of ovarian cancer chemoprevention are those who are at higher risk of ovarian cancer either through individual risk factors or due to genetic mutations, as the benefit of preventing ovarian cancer in this group likely offsets or outweighs the risk of side effects from the medication use. Our group was funded previously to conduct a comprehensive analysis to understand whether aspirin could prevent ovarian cancer. As part of this research, we expanded the data resources in the Ovarian Cancer Cohort Consortium (OC3, including data from 13 large observational cohort studies) to include information on over-the-counter medications use (e.g., aspirin, Tylenol, ibuprofen), lifestyle factors, ovarian cancer risk factors, and ovarian cancers diagnoses. We found that aspirin reduced the risk of ovarian cancer and that women who are at higher risk of ovarian cancer due to the presence of one or more ovarian cancer risk factors (e.g., positive family history, never oral contraceptive use, no pregnancies) may be more likely to benefit from frequent aspirin use to reduce ovarian cancer risk. Unfortunately, we did not have the support to also collect the existing data on prescription medication use from all studies, and were not able to evaluate whether the benefit of aspirin was changed or altered by prescription medication use. Research evaluating statins and/or bisphosphonates as preventive agents for ovarian cancer have shown mixed results. However, encouraging preclinical and epidemiologic data, as well as the broad access, low cost, and low risk of major adverse side effects, makes the concept of repurposing these drugs for ovarian cancer chemoprevention appealing. It is also possible that prescription medication (i.e., statins or bisphosphonates) used alone or in combination with aspirin could also prevent ovarian cancer. Problem to Be Addressed and How It Will Advance the Field: The proposed research both expands and extends our previous research as follows: Aim 1. The project expands on our previous research to evaluate whether use of both aspirin and prescription medication use enhances or reduces the chemopreventive benefits of aspirin in reducing ovarian cancer risk. Aim 2. The project extends our prior research to evaluate whether common prescription medications, particularly those that affect an important pathway of cellular and lipid metabolism (i.e., statins or bisphosphonates), may be used to prevent ovarian cancer and to identify groups of women that will receive the most benefit from these medications.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310247
Entities
People
- Britton Trabert
Organizations
- United States Army
- University of Utah