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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
The trial did not change practice, but it established the idea that the days around surgery are a window in which cheap interventions might reduce metastasis, a line the same group pursued to a positive result with peritumoral lidocaine in 2023. It is a reminder that subgroup findings need confirmation, which is still awaited.
Shares Metastasis is understood least and studied last, No incentive to repurpose cheap drugs, HR-positive / HER2-negative breast cancer.
Shares Metastasis is understood least and studied last, No incentive to repurpose cheap drugs, HR-positive / HER2-negative breast cancer.
Shares Metastasis is understood least and studied last, Overall survival (OS), HR-positive / HER2-negative breast cancer.
Shares Tata Memorial Centre, No incentive to repurpose cheap drugs, Triple-negative breast cancer (TNBC).
Shares Metastasis is understood least and studied last, Overall survival (OS), Triple-negative breast cancer (TNBC).
Shares Metastasis is understood least and studied last, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Metastasis is understood least and studied last, No incentive to repurpose cheap drugs, HR-positive / HER2-negative breast cancer.
Shares Tata Memorial Centre, Overall survival (OS), Surgery and radiotherapy cure most, get least.