Patients with colorectal cancer with mutated PIK3CA, identified from two large observational cohorts, had increased cancer-specific and overall survival if they used aspirin regularly after diagnosis compared to non-users. No effect of aspirin was seen in patients with wild-type PIK3CA. Mutated PIK3CA might be a useful biomarker to select patients who would benefit from adjuvant aspirin therapy.
Key Points
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Patients with colorectal cancer with mutated PIK3CA, identified from two large observational cohorts, had increased cancer-specific and overall survival if they used aspirin regularly after diagnosis compared to non-users
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Randomized trials specifically designed to assess the role of aspirin in the treatment of cancer are needed and to assess the potential value of PIK3CA as a biomarker of aspirin response
References
Langley, R. E. et al. Aspirin and cancer: has aspirin been overlooked as an adjuvant therapy? Br. J. Cancer 105, 1107–1113 (2011).
Rothwell, P. M. et al. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 376, 1741–1750 (2010).
Rothwell, P. M. et al. Long-term effect of aspirin on deaths due to cancer: pooled analysis of data from randomised controlled trials. Lancet 377, 31–41 (2011).
Rothwell, P. M. et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet 379, 1602–1612 (2012).
Burn, J. et al. Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet 378, 2081–2087 (2012).
Rothwell, P. M. et al. Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Lancet 379, 1591–1601 (2012).
Chan, A. T., Ogino, S. & Fuchs, C. S. Aspirin use and survival after diagnosis of colorectal cancer. JAMA 302, 649–658 (2009).
Liao, X. et al. Aspirin use, tumour PIK3CA mutation and colorectal-cancer survival. N. Engl. J. Med. 367, 1596–1606 (2012).
Thun, M. J., Jacobs, E. J. & Patrono, C. The role of aspirin in cancer prevention. Nat. Rev. Clin. Oncol. 9, 259–267 (2012).
Holmes, M. D. et al. COX-2 expression predicts worse breast cancer prognosis and does not modify the association with aspirin. Breast Cancer Res. Treat. 130, 657–662 (2011).
Acknowledgements
P. M. Rothwell is partly funded by Senior Investigator Awards from the National Institute of Health Research (NIHR) and the Wellcome Trust.
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P. M. Rothwell and R. E. Langley have received an honorarium from the Aspirin Foundation for speaking at a conference. P. M. Rothwell has also received honoraria for talks, advisory boards and clinical trial committees from several pharmaceutical companies with an interest in antiplatelet agents, including Astra-Zeneca, Bayer, Boehringer Ingelheim, Sanofi-BMS and Servier, and is on the Executive Committee of the ASCOLT and ARRIVE trials.
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Langley, R., Rothwell, P. Potential biomarker for aspirin use in colorectal cancer therapy. Nat Rev Clin Oncol 10, 8–10 (2013). https://doi.org/10.1038/nrclinonc.2012.216
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DOI: https://doi.org/10.1038/nrclinonc.2012.216
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