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April 16, 2014
Aspirin Aids Survival in Some Colon Cancer Types

Leiden, The Netherlands—The newest drug found to aid survival in certain types of colon cancer could be purchased inexpensively at any pharmacy and in many other retail outlets.

Dutch researchers have found that taking low doses of aspirin after a colon cancer diagnosis appears to be associated with better survival if the tumor cells express HLA class I antigen. Their study, published recently in JAMA Internal Medicine, suggests the drug works by inhibiting platelet function.

In the article’s background, Leiden University Medical Center researchers note that prior research has raised the possibility that aspirin use after a colorectal cancer diagnosis might improve survival. While the precise mechanism of aspirin’s anticancer effect is unknown, the authors say that previous data posit that aspirin may prevent distant metastasis in colorectal cancer.

For the study, investigators examined tumor tissue from 999 patients with colon cancer who underwent surgery between 2002 and 2008. Tissue samples were examined for HLA class I antigen and prostaglandin endoperoxide synthase 2 (PTGS2) in the patients, most of whom had colon cancer diagnosed at stage III or lower. A prescription database was used to determine which of the 999 patients had received a prescription for aspirin for 14 days or more.

Results indicate that 37.9% of the 182 aspirin users died compared to 48.5% of the 817 nonusers of aspirin.

“The potential survival benefit of aspirin was strongest among patients with HLA I antigen expression,” according to the study. “The molecular reasons underlying the effects of aspirin are not completely understood, but the authors suggest the results are likely the effect of aspirin on circulating tumor cells and their ability to develop into metastatic deposits.”

Aspirin does not appear to improve survival for all colon cancer patients, however, the authors write.

“We found that the survival benefit associated with low-dose aspirin use after a diagnosis of colon cancer was significantly associated with HLA class I antigen-positive tumors,” they write. “In contrast, in patients whose tumors had lost their HLA class I antigen expression, aspirin use did not change the outcome.”

In a related commentary, Alfred I. Neugut, MD, PhD, of Columbia University, New York, suggests the study gives physicians another weapon in their arsenal against colon cancer.

“When one sees a patient newly diagnosed as having cancer, after finishing the initial discussion and treatment plan, it is almost inevitable that the patient or a family member will inquire, ‘What else should he [or she] do?’” Neugot writes.

“For my own patients, I have so far not recommended aspirin [for colon cancer]. But I think based on current evidence, that if I personally had a stage III tumor, I would add aspirin to my FOLFOX (folinic acid-flourouracil-oxaliplatin) adjuvant therapy. And if I feel that way for myself, should I not convey that to my patients?” he adds.

“But for now, as far as I am concerned, when a patient or a patient's spouse asks, "What else should he be doing, Doctor?”—I will have a ready response,” Neugut concludes.




U.S. Pharmacist Social Connect