An Update on Existing Ongoing Prospective Trials Evaluating the Effect of Anesthetic and Analgesic Techniques During Primary Cancer Surgery on Cancer Recurrence or Metastasis

Royds, Jonathan; Khan, Abdul Hameed; Buggy, Donal J.

doi:10.1097/aia.0000000000000123

Cited by 23 publications

(26 citation statements)

References 20 publications

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“…In clinical practice, surgery for breast cancer may be performed under general anesthesia with or without regional anesthesia. The addition of regional anesthesia in the form of a paravertebral block has been shown to be associated with a longer recurrence free period for patients with breast cancers following surgical resection [ 2 ]. Recent retrospective studies have also shown that regional anesthesia improved patient outcome after surgery for other cancers [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The addition of regional anesthesia in the form of a paravertebral block has been shown to be associated with a longer recurrence free period for patients with breast cancers following surgical resection [ 2 ]. Recent retrospective studies have also shown that regional anesthesia improved patient outcome after surgery for other cancers [ 2 , 3 ]. In addition, the involvement of local anesthetics perioperatively and postoperatively could reduce the use of systemic opioid for pain management [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the involvement of local anesthetics perioperatively and postoperatively could reduce the use of systemic opioid for pain management [ 4 ]. Large-scale prospective clinical studies are currently ongoing to further investigate the potential benefit of local anesthetics [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of local anesthetics on breast cancer cell viability and migration

et al. 2018

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BackgroundBreast cancer accounts for nearly a quarter of all cancers in women worldwide, and more than 90% of women diagnosed with breast cancer undergo mastectomy or breast-conserving surgery. Retrospective clinical studies have suggested that use of regional anesthesia leads to improved patient outcomes. Laboratory studies have reported that breast cancer cells are inhibited by some local anesthetics at millimolar concentration. Here, we present a comprehensive analysis of the effects of six common local anesthetics on two human breast cancer cell lines. We used concentrations ranging from those corresponding to plasma levels during regional block by local anesthetic (plasma concentration) to those corresponding to direct infiltration of local anesthetic.MethodsHuman breast cancer cell lines, MDA-MB-231 and MCF7, were incubated with each of six local anesthetics (lidocaine, mepivacaine, ropivacaine, bupivacaine, levobupivacaine, and chloroprocaine) (10 μM ~ 10 mM) for 6 to 72 h. Assays for cell viability, cytotoxicity, migration, and cell cycle were performed.ResultsHigh concentrations (> 1 mM) of local anesthetics applied to either MDA-MB-231 or MCF7 cells for 48 h significantly inhibited cell viability and induced cytotoxicity. At plasma concentrations (~ 10 μM) for 72 h, none of the local anesthetics affected cell viability or migration in either cell line. However, at 10 × plasma concentrations, 72-h exposure to bupivacaine, levobupivacaine or chloroprocaine inhibited the viability of MDA-MB-231 cells by > 40% (p < 0.001). Levobupivacaine also inhibited the viability of MCF7 cells by 50% (p < 0.001). None of the local anesthetics affected the viability of a non-cancerous breast cell line, MCF10A. MDA-MB-231 cell migration was inhibited by 10 × plasma concentrations of levobupivacaine, ropivacaine or chloroprocaine and MCF7 cell migration was inhibited by mepivacaine and levobupivacaine (p < 0.05). Cell cycle analysis showed that the local anesthetics arrest MDA-MB-231 cells in the S phase at both 1 × and 10 × plasma concentrations.ConclusionsLocal anesthetics at high concentrations significantly inhibited breast cancer cell survival. At 10 × plasma concentrations, the effect of local anesthetics on cancer cell viability and migration depended on the exposure time, specific local anesthetic, specific measurement endpoint and specific cell line.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of local anesthetics on breast cancer cell viability and migration

et al. 2018

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“…This has made the PI3K/Akt/mTOR signalling pathway an important object of study for understanding the development and progression of breast cancer. In patients with breast cancer, PI3K/Akt/mTOR signalling pathway can be a target for diagnostic, prognostic and treatment purposes [2,[42][43][44][45][46][47]. Akt plays a role in the activation and inactivation of many transcription factors.…”

Section: Discussionmentioning

confidence: 99%

Levobupivacaine inhibits proliferation and promotes apoptosis of breast cancer cells by suppressing the PI3K/Akt/mTOR signalling pathway

Kwakye

Kampo

et al. 2020

Preprint

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Objective This study aimed to test the hypothesis that levobupivacaine has anti-tumour effects on breast cancer cells Results Colony formation and transwell assay were used to determine breast cancer cells proliferation. Flow Cytometry (annexin V and PI staining) was used to investigate breast cancer cells apoptosis. The effects of levobupivacaine on cellular signalling and molecular response were studied with Quantitative Polymerase Chain Reaction and western blot. Induction of apoptosis was confirmed by cell viability, morphological changes showed cell shrinkage, rounding, and detachments from plates. The results of the western blot and Quantitative Polymerase Chain Reaction indicated activation of active caspase-3 and inhibition of FOXO1. The results of the flow Cytometry confirmed that levobupivacaine inhibited breast cancer cell proliferation and enhanced apoptosis of breast cancer cells. Quantitative Polymerase Chain Reaction and Western blot analysis showed increased p21 and decreased cyclin D. Quantitative Polymerase Chain Reaction and western blot analysis showed that levobupivacaine significantly increased Bax expression, accompanied by a significant decreased Bcl-2 expression and inhibition of PI3K/Akt/mTOR signalling pathway. These findings suggested that levobupivacaine inhibits proliferation and promotes breast cancer cells apoptosis in vitro.

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“…5 Retrospective clinical studies have suggested that the use of regional anesthesia leads to improved patient outcomes. 6,7 Laboratory studies have reported that colon cancer cells are inhibited by some local anesthetics. 8 However, the application of local anesthetics in colon cancer treatment is limited by our understanding of the mechanisms underlying their effects on cancer biology.…”

Section: Introductionmentioning

confidence: 99%

A Prospective for the Potential Effect of Local Anesthetics on Stem-Like Cells in Colon Cancer

Liu¹

2020

GJMR

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Colorectal cancer is the third most prevalent cancer and the second most frequent cause of cancer-related death in the world. Surgical resection of the primary tumor is the central aspect of the current multiple modes of treatment and has been associated with better prognosis. The process of surgery, including anesthetic regimens, has increasingly been recognized to affect colon cancer recurrence and metastasis. Both retrospective clinical studies and laboratory studies have reported that colon cancer cells are inhibited by some local anesthetics. However, the application of local anesthetics in colon cancer treatment is limited by our understanding of the mechanisms underlying their effects on cancer biology. Local anesthetics have been proved to preferentially inhibit cancer stem cells which imply that local anesthetics target colon cancer stem cell to suppress cancer progressing. Here this paper will review and propose several potential studies, including using colon cancer cell lines and animal models to test the effect of local anesthetics on population, viability, and migration of colon cancer stem-like cell, and screen and search for potential molecular targets underlying these effects.

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An Update on Existing Ongoing Prospective Trials Evaluating the Effect of Anesthetic and Analgesic Techniques During Primary Cancer Surgery on Cancer Recurrence or Metastasis

Cited by 23 publications

References 20 publications

Effects of local anesthetics on breast cancer cell viability and migration

Effects of local anesthetics on breast cancer cell viability and migration

Levobupivacaine inhibits proliferation and promotes apoptosis of breast cancer cells by suppressing the PI3K/Akt/mTOR signalling pathway

A Prospective for the Potential Effect of Local Anesthetics on Stem-Like Cells in Colon Cancer

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