Harvard University. US: Some NSAIDs can stem the growth of a common intracranial tumor. Researchers from the Harvard-MIT Program in Speech and Hearing Bioscience and Technology
 and Massachusetts Eye and Ear have demonstrated that salicylates, a 
class of nonsteroidal inflammatory drugs (NSAIDs), reduced the 
proliferation and viability of cultured vestibular schwannoma cells that
 cause a sometimes lethal intracranial tumor that typically causes 
hearing loss and tinnitus.
The research is described online in Translational Research.
“These preclinical data based on cultured primary vestibular 
schwannoma cells, combined with our previously published work on aspirin
 intake correlating with halted growth of vestibular schwannomas (also 
known as acoustic neuroma), motivate a future prospective clinical 
trial,” said Konstantina Stankovic,
 HMS assistant professor of otology and laryngology and principal 
investigator at the Eaton-Peabody Laboratories at Mass Eye and Ear.
Vestibular schwannomas are the most common tumors of the 
cerebellopontine angle and the fourth most common intracranial tumors. 
Although vestibular schwannomas are histologically nonmalignant, they 
can lead to substantial morbidity, including sensorineural hearing loss,
 vestibular dysfunction and facial nerve paralysis. Large vestibular 
schwannomas can cause additional paralysis of other cranial nerves, 
brainstem compression and death, the authors write.
Currently, patients with symptomatic or growing vestibular 
schwannomas can undergo surgical resection or radiotherapy. Both of 
these procedures can result in serious complications. Effective drug 
therapies that can limit growth would greatly advance health care for 
these patients.
Salicylates are attractive therapeutics because they are clinically 
relevant, well tolerated and commonly used against pathologies such as 
pain and arthritis. Furthermore, in some cases, chronic intake of 
salicylates has led to a significant reduction in the incidence and 
burden of various tumors, such as colorectal cancer.
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“In our study, we focused on salicylates because a mechanism of their
 action is inhibition of cyclooxygenase 2 (COX-2), and a previous study 
reported that immunohistochemical expression of COX-2 correlated with 
vestibular schwannoma growth rates. We assessed the efficacy of three 
different salicylates against vestibular schwannoma: aspirin, sodium 
salicylate (NaSal) and 5-aminosalicylic acid (5-ASA),” Stankovic said.
The team found COX-2 to be aberrantly expressed in human vestibular 
schwannomas and primary human vestibular schwannoma cells in comparison 
to control human nerve specimens and primary Schwann cells (SCs), 
respectively. Further, levels of prostaglandin E2, the downstream 
enzymatic product of COX-2, correlated with the primary vestibular 
schwannoma culture proliferation rate. Changes in proliferation, cell 
death and cell viability were analyzed in primary vestibular schwannoma 
cultures treated with aspirin, NaSal or 5-ASA. These drugs decreased 
proliferation and viability of vestibular schwannoma cells without 
increasing cell death or affecting healthy schwannoma cells. The 
cytostatic effect of aspirin in vitro was consistent with Stankovic’s 
previous clinical finding that vestibular schwannoma patients taking 
aspirin demonstrate reduced tumor growth.
”Overall, this work suggests that COX-2 is a key modulator in 
vestibular schwannoma cell proliferation and survival and highlights 
salicylates as promising pharmacotherapies against vestibular 
schwannoma,” the authors concluded.
This study was supported by the National Institute on Deafness and 
Other Communication Disorders grants T32 DC00038 and K08DC010419, the 
Bertarelli Foundation and Department of Defense grant W81XWH-14-1-0091.
Adapted from a Mass Eye and Ear news release.