Aspirin recovers the risk of recurrence in patients with colorectal cancer, clinical trials find

A research team led by the Swedish at the Karolinska Institute and at the Karolinska University Hospital has shown in a new randomized clinical trial that a low dose of well -known medication aspirin reticulated the risk of recurrence after surgery in patients with colon and rectal cancer with a certain type of genetic alteration in the tumor.

Each year, nearly two million people worldwide are diagnosed with colorectal cancer. Between 20 and 40% develop metastases, which makes the disease that are both more difficult to treat and more deadly.

Previous observation studies have suggested that aspirin can reduce the risk of certain cancers and perhaps also the risk of recurrence after surgery in colorectal cancer patients hosting mutations in the genes of the PIK3 signaling route.

These genes regulate key cellular processes such as growth and division. When mutated, these processes can become unrestrained, leading to uncontrolled cell proliferation and a development of cancer. However, the previous results were incoherent and no randomized clinical trial had previously confirmed the association. To fill this gap, the Alascca test has been launched and has now been published in The New England Journal of Medicine.

This study included more than 3,500 patients with colon and rectum cancer of 33 hospitals in Sweden, Norway, Denmark and Finland. Patients whose tumors have shown a specific genetic mutation in the PIK3 signaling track – a mutation found in around 40% of patients – were randomized to receive 160 mg of aspirin per day or a placebo for three years after surgery.

For patients with genetic mutation in PIK3, the risk of recurrence has been reduced by 55% in those who received aspirin compared to the placebo group.

“Aspirin is tested here in a whole new context as a treatment of precision medicine. This is a clear example of how we can use genetic information to personalize treatment and at the same time save resources and suffering,” said the first author Anna Martling, professor in the Department of Molecular Medicine and Surgery, Karinska Institutet, and Senior Senior Consultant Karolinska.

So how does aspirin reduce the risk of recurrence of colon and rectum cancer? Researchers think that the effect is probably due to aspirin acting through several parallel mechanisms – it reduces inflammation, inhibits platelet function and tumor growth. This combination makes the environment less favorable to cancer.

“Although we do not yet fully understand all molecular links, the results strongly support the biological justification and suggest that the treatment can be particularly effective in the genetically defined subgroups of patients,” explains Martling.

Researchers think that the results could have global meaning and influence treatment guidelines for colon and rectum cancer in the world. Martling sees the fact that the drug is well established as a major advantage.

“Aspirin is a drug that is easily available worldwide and extremely cheap compared to many modern cancer drugs, which is very positive,” said Martling.