Tel Aviv University Scientists Successfully Reduce Metastatic Spread Following Tumor Removal Surgery

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A Study Performed in Colorectal Cancer Patients Found that Implementing a Stress-Inflammatory Response Reducing Treatment During Surgery Could Lead to a Decrease in Metastatic Risk

A research group from Tel Aviv University successfully reduced metastatic spread following tumor removal surgery in colorectal cancer patients. Using a short medication treatment around the time of the surgery, the researchers were able to reduce body stress responses and physiological inflammation during this critical period, thus preventing the development of metastases in the years following the surgery. The study, which was recently published in “Cancer”, was led by Prof. Shamgar Ben-Eliyahu from TAU School of Psychological Sciences and Sagol School of Neuroscience, and Prof. Oded Zmora from Shamir (Assaf Harofeh) Medical Center.

During the study, which lasted 3 years, the researchers have monitored 34 patients, who received treatment surrounding a colorectal tumor removal surgery. During the pre- and post-surgical period, the patients were administered two safe and known drugs: Propranolol (Deralin), an anti-anxiety and blood pressure reducing drug, and Etodolac (Etopan), an anti-inflammatory analgesic. The drugs were only administered to the patients for 20 days – starting from 5 days prior to surgery, and until two weeks after – with half of the patients receiving a placebo treatment, as a control group.

The results are highly promising: while only 12.5% (2 out of 16) of patients receiving the drugs treatment exhibited metastatic disease, in the control group (which did not receive the treatment) the rate of metastases development was found to be 33% (6 out of 18 patients), which is the known rate for colorectal cancer patients. Prof. Ben-Eliyahu says that he is highly satisfied with these data, but also states that “despite the impressive results, this treatment must be examined again, in a much larger number of patients, in order to test whether it is, in fact, life-saving”.

According to Prof. Ben-Eliyahu, the study of molecular markers in the cancerous tissue excised from the patients showed that the treatment with the medications has led to a reduction in the metastatic potential of the tumor and potentially the residual cancer cells. In addition, the drugs triggered some beneficial alterations in infiltrating tumor leukocytes (patients’ white blood cells) number and type – which are also markers indicating a reduced chance of disease recurrence.

Prof. Ben-Eliyahu explains: “When the body is in a state of stress, whether physiological (from surgery) or psychological, this causes a release of high amounts of two types of hormones, prostaglandins and catecholamines. These hormones suppress the activity of the immune cells, thus indirectly promoting the development of cancer metastases. In addition, these hormones also directly promote the acquisition of metastatic traits in cancer tissue. Our study shows that inexpensive, accessible medication treatment could be used in order to reduce body stress responses and inflammation associated with surgery, which affects the tumor, significantly reducing the risk of metastases that might be detected months or years after surgery.”

Following the success of the initial research, Prof. Ben-Eliyahu and Prof. Zmora encourage Israeli colorectal and pancreatic cancer patients, intended for surgery, to apply for participation in a large-scale clinical study which is now starting across the State in eight different Medical Centers – in order to save lives.

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