Aspirin therapy extends life in colorectal cancer patients with specific gene mutation

by Bruce Sylvester – taken from the New England Journal of Medicine (NEJM) – Aspirin therapy appears to extend life in colorectal cancer patients with tumors having a mutation in a key gene, but has no effect on patients without the mutation, researchers reported October 25 in the New England Journal of Medicine.

For the retrospective study, they gathered data on 964 subjects diagnosed with rectal or colon cancer from the Nurses’ Health Study and the Health Professionals Follow-up Study. The data included information on aspirin-use after diagnosis and the presence or absence of PIK3CA mutations in tumor tissue.
The investigators found that, among patients whose tumors had a mutation in the gene PIK3CA, aspirin use led to a significant increase in survival, compared to non-aspirin users. Five years following diagnosis, 97% of those using aspirin were alive, compared with 74% of non-users.

However, aspirin-use showed no effect on 5-year survival rates among subjects without a PIK3CA mutation.

“Our results suggest that aspirin can be particularly effective in prolonging survival among patients whose colorectal cancer tests positive for a mutation in PIK3CA,” said senior author Shuji Ogino, MD, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital, Boston, Massachusetts. “For the first time, we have a genetic marker that can help doctors determine which colorectal cancers are likely to respond to a particular therapy.”

He noted that the results need to be replicated before they become definitive.