{"entity":{"id":"lidocaine-peritumoral-tmh","kind":"trial","name":"Peritumoral lidocaine before breast cancer surgery (Tata Memorial)","aka":[],"tldr":"Injecting a common local anaesthetic around the tumour minutes before surgery cut the risk of recurrence and death in a 1,583-woman Indian trial, at almost no cost.","summary":"1,583 women with early breast cancer were randomised to peritumoral lidocaine (n=796) or no injection (n=804) before surgery. At 5 years disease-free survival was 86.6% versus 82.6% (hazard ratio 0.74; P=0.017), overall survival 90.1% versus 86.4% (hazard ratio 0.71; P=0.019) and distant recurrence 8.5% versus 11.6% (hazard ratio 0.73), with no adverse events from the intervention. The proposed mechanism is blockade of voltage-gated sodium channels and surgery-induced tumour cell activation and dissemination. Confirmation in other populations is awaited before guideline adoption, but the trial is a model of the cheap, mechanism-led perioperative interventions Tata Memorial has pursued for two decades.","status":"positive","asOf":"2026-09-10","links":[{"label":"Badwe et al., JCO 2023","url":"https://doi.org/10.1200/JCO.22.01966"}],"tags":[],"related":[],"cancers":["breast-hr-positive","tnbc","breast-her2-positive"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["tata-memorial"],"pathways":[],"terms":["os"],"trials":[],"people":["badwe-rajendra"],"bottlenecks":["b-generic-repurposing","b-surgery-radiation-innovation","b-metastasis-biology"],"keyPapers":["paper-badwe-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Early breast cancer: peritumoral infiltration of 0.5% lidocaine immediately before surgery vs surgery alone","sponsor":"Tata Memorial Centre","result":"5-year DFS 86.6% vs 82.6% (HR 0.74); OS 90.1% vs 86.4% (HR 0.71).","yearReported":2023,"enrolled":1583,"enrolledBasis":"registry","outcomes":[{"endpoint":"5-year disease-free survival","primary":true,"unit":"%","arms":[{"name":"Peritumoral lidocaine","n":796,"value":86.6},{"name":"No lidocaine","n":804,"value":82.6}],"hr":0.74,"p":"0.017","source":"https://doi.org/10.1200/JCO.22.01966"},{"endpoint":"5-year overall survival","unit":"%","arms":[{"name":"Peritumoral lidocaine","value":90.1},{"name":"No lidocaine","value":86.4}],"hr":0.71,"p":"0.019","source":"https://doi.org/10.1200/JCO.22.01966"}]},"route":"/trials/lidocaine-peritumoral-tmh/","neighbours":{"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"institution":[{"id":"tata-memorial","kind":"institution","name":"Tata Memorial Centre","route":"/institutions/tata-memorial/"}],"term":[{"id":"os","kind":"term","name":"Overall survival (OS)","route":"/terms/os/"}],"person":[{"id":"badwe-rajendra","kind":"person","name":"Rajendra Badwe","route":"/people/badwe-rajendra/"}],"bottleneck":[{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"},{"id":"b-generic-repurposing","kind":"bottleneck","name":"No incentive to repurpose cheap drugs","route":"/bottlenecks/b-generic-repurposing/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}],"paper":[{"id":"paper-badwe-j-clin-oncol","kind":"paper","name":"Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer","route":"/key-papers/paper-badwe-j-clin-oncol/"},{"id":"paper-badwe-progesterone-jco-2011","kind":"paper","name":"Single-injection depot progesterone before surgery and survival in operable breast cancer","route":"/key-papers/paper-badwe-progesterone-jco-2011/"}],"trial":[{"id":"progesterone-preop-tmh","kind":"trial","name":"Single-injection depot progesterone before breast surgery (Tata Memorial)","route":"/trials/progesterone-preop-tmh/"}]}}