Breast cancer patients who receive a peritumoral injection of lidocaine immediately before surgery have better survival outcomes, according to research published in the Journal of Clinical Oncology.
The injection significantly increased disease-free survival (DFS) and overall survival (OS) in patients with early operable breast cancer who did not receive neoadjuvant treatment, researchers found.
In this open-label, randomized, phase 3 trial (ClinicalTrials.gov Identifier: NCT01916317), researchers analyzed the potential antimetastatic effects of local anesthesia injections 7-10 minutes before scheduled surgery for early breast cancer.
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The study included 1583 evaluable breast cancer patients who were separated into 2 groups — those who received a peritumoral injection of 0.5% lidocaine immediately before surgery (n=786) and those who did not (n=797). Baseline characteristics were well balanced between the arms.
The median follow-up was 69 months, and the primary endpoint was DFS. The 5-year DFS rate was 86.6% for lidocaine recipients and 82.6% for patients who did not receive lidocaine (hazard ratio [HR], 0.74; 95% CI, 0.58-0.95; P =.017).
The 5-year cumulative incidence of locoregional recurrence was 3.2% for lidocaine recipients and 4.1% for the control group (subdistribution HR [SHR], 0.69; 95% CI, 0.42-1.13). The 5-year distant recurrence rate was 8.1% and 10.9%, respectively (SHR, 0.74; 95% CI, 0.54-1.01).
The 5-year OS rate was 90.1% for lidocaine recipients and 86.4% for patients who did not receive lidocaine (HR, 0.71; 95% CI, 0.53-0.94; P =.019).
There were no adverse events related to lidocaine.
“In summary, peritumoral injection of lidocaine before breast cancer surgery significantly increases DFS and OS,” the researchers concluded. “Altering events at the time of surgery can prevent metastases in early breast cancer, and more such interventions need to be explored in future studies.”
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Badwe RA, Parmar V, Nair N, et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. Published online April 6, 2023. doi:10.1200/JCO.22.01966
This article originally appeared on Cancer Therapy Advisor
