The finding is also not without precedent. The authors cited one Scandinavian randomized trial in which a single course of perioperative cyclophosphamide significantly improved disease-free survival at more than 17 years of follow-up; by contrast, giving the treatment 2-4 weeks after mastectomy provided no such benefit.
In addition, ketorolac’s potential perioperative benefit has been shown in other tumor types, including improved disease-free survival in one institutional series of lung cancer patients, and reduced disease-specific mortality in a retrospective study of ovarian cancer patients.
The present breast cancer study is limited because it is retrospective, and does not address questions regarding optimal timing or duration of dose. However, “it suggests a potentially important repositioning of ketorolac in the intraoperative treatment of breast cancer patients with elevated BMI, and points to the need for a prospective confirmatory randomized trial,” the authors said.
Dr. Desmedt and her colleagues reported no conflicts of interest related to the study.
SOURCE: Desmedt C et al. J Natl Cancer Inst. 2018 Apr 30. doi: 10.1093/jnci/djy042.