Emerging Role of Local Anaesthetics in Ovarian Cancer Treatment

Ovarian cancer (OC) is a gynaecological disease mostly arising from the epithelium of the ovary _[1]. Age, smoking, obesity and the BRCA genes are key risk factors, but OC is a complex disease that can develop at any age and from different locations in the ovary, including granulose cells, oocytes, theca interstitial cells and the epithelium surface _[1]. Incidences of ovarian cancer have increased by over 90% since 1990, with approximately 310,000 women diagnosed with the disease globally _[2]. An aging population is a huge contributor to increased rates with the highest incidences recorded in women aged 70 to 74 _[2]. Most treatment strategies include surgery to remove the tumour, followed by sequential chemotherapy, however scientists have delved into another type of treatment for ovarian cancer – local anaesthetics (LAs). LAs have shown success in reducing cancer cell migration and proliferation as well as increasing apoptosis, a key and desired effect of anti-cancer treatments _[3].

Hayden et al. investigated the effect of ropivacaine and lidocaine, two types of LAs, on cell proliferation and cell migration of three ovarian cancer cell lines: SKOV-3, SW-626 and CA-OV-3. Cell lines were tested in 95% air and 5% CO₂ with a concentration range of 1 to 1000μM of ropivacaine and lidocaine. Treatment with 1000μM ropivacaine or lidocaine reduced cell numbers in lines SW-626 and CA-OV-3 after a 72-hour period; SK-OV-3 showed significant inhibitory effects. Except for lidocaine in cell line SK-OV-3, both LAs inhibited migration potential in all three cell lines. In addition, they found that ropivacaine treatment reduced cells with cancer stem cell phenotypes by 50%, which is vital as these cancer cells continuously regenerate and play a significant role in tumour progression, so findings of this kind are promising. As well as being tested in air, these experiments were conducted under hypoxic conditions (1% O₂) in a Whitley Hypoxic Workstation; hypoxia is a fundamental characteristic of the tumour microenvironment, so it is imperative to observe the effect of LAs in low oxygen levels. They found that all cell lines were sensitive to ropivacaine and lidocaine in hypoxia, with SK-OV-3 showing sensitivity that was not seen in normoxia _[4].

Encouraging results in terms of cancer cell behaviour from this study shows promise for the use of LAs in OC treatment. The use of such low concentrations in this study is advantageous as administration is achievable not just systemically, but also locally. Ultimately, LAs are another avenue for scientists and clinicians to explore in OC treatment and further in vitro studies should be conducted, with the hope of progression to in vivo and clinical studies, and one day clinical use.

Written by DWS Microbiologist Kirsty McTear

References

1. Ali AT, Al-ani O, Al-ani F. Epidemiology and risk factors for ovarian cancer. Menopause Rev . 2023 Mar 1;22(2):93–104.
2. Gui J. Analysis of global ovarian cancer disease burden and its changing trend from 1990 to 2021. BMC Women’s Health. 2025 Jun 16;25(352).
3. Koo CH, Baik J, Shin HJ, Kim JH, Ryu JH, Han SH. Neurotoxic Effects of Local Anesthetics on Developing Motor Neurons in a Rat Model. Journal of Clinical Medicine. 2021 Feb 25;10(5):901.
4. Hayden JM, Tinnert A, Alm K, Oras J, Block L, Gupta A, et al. Ropivacaine and lidocaine at clinically relevant concentrations suppress proliferation and migration of ovarian cancer cells and induce morphological alterations. Advances in Medical Sciences. 2025 Oct;70(2):326–34.