In a nutshell
This study evaluated the efficacy of aspirin in relation to PIK3CA gene status of patients with colorectal cancer.
Some background
Aspirin is a drug used for pain relief and fever reduction. Its anti-inflammatory properties are associated with its ability to inhibit the cyclooxygenase-2 (COX-2) enzyme. The COX-2 enzyme also appears to be involved in the growth of new blood vessels, which are essential for growth and spread of colorectal cancer. PIK3CA is a gene responsible for the production and activity of cyclooxygenase-2 enzyme. A mutated PIK3CA gene is also commonly found in some colorectal cancer cells.
Regular use of aspirin has been shown to improve survival among colorectal cancer patients. However, the effect of aspirin on survival among patients with mutated-PIK3CA colorectal cancers might differ from the effect among those with non-mutated (wild-type) PIK3CA tumors.
Methods & findings
A total of 964 patients with colorectal cancer were involved in this study. 803 patients had wild-type PIK3CA tumors while 161 had mutated tumors. These patients were followed up for an average period of 153 months.
Among patients with mutated-PIK3CA tumors, regular use of aspirin after diagnosis was associated with significantly longer cancer-specific survival (the length of time during which patients have not died from cancer). In patients with mutated-PIK3CA tumors taking aspirin, the probability of death during the study period was reduced by 82% compared to those not taking aspirin. Conversely, in those with wild-type tumors taking aspirin the probability of death during the study period was reduced by 4% compared to those those not taking aspirin.
Among patients with mutated-PIK3CA tumors, 26% of patients who did not use aspirin after diagnosis died within 5 years after diagnosis, whereas only 3% of regular users of aspirin after diagnosis died within 5 years after diagnosis. In contrast, among patients with wild-type PIK3CA tumors, 15% of patients from both groups died within 5 years of diagnosis, regardless of aspirin intake.
The bottom line
In summary, this study concluded that regular use of aspirin after diagnosis significantly increased survival among patients with mutated-PIK3CA colorectal cancer, but not among patients with wild-type PIK3CA cancer.
The fine print
What’s next?
Consult with your physician regarding the risks and benefits of aspirin in the treatment of colorectal cancer.
Published By :
The New England Journal of Medicine
Date :
Oct 25, 2012
