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Aspirin Therapy Allows Colorectal Cancer Patients With Gene Mutation to Live Longer

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For patients without the mutation, aspirin had no impact on survival rates

When taken by colorectal cancer patients whose tumors carry a mutation in a key gene, aspirin can extend life. However, aspirin therapy has no effect on colorectal cancer patients who lack the mutation.

In a study involving more than 900 patients with colorectal cancer, Dana-Farber Cancer Institute scientists found that, for patients whose tumors included a mutation in the gene PIK3CA, aspirin use produced a sharp increase in survival. Of those patients taking aspirin, 97% were still alive 5 years following diagnosis, compared with 74% of those not taking aspirin. By contrast, aspirin had no impact on 5-year survival rates among patients without a PIK3CA mutation.

To conduct the study, which is published in a recent issue of the New England Journal of Medicine, researchers examined data from the Nurses’ Health Study and the Health Professionals Follow-up Study on 964 patients with rectal or colon cancer. Included in the data was information on the patients’ use of aspirin after diagnosis and the presence or absence of PIK3CA mutations in their tumor tissue.

Aspirin is often prescribed for colorectal cancer patients; however, doctors haven’t been able to predict which patients will actually benefit from the treatment. The new study findings suggest the survival benefit is limited to the 20% whose tumors have the PIK3CA mutation.

Aspirin may still be used for the remaining 80% of patients, but it is likely to be much less effective. Aspirin can sometimes have side effects, including gastrointestinal ulcers and stomach bleeding.

“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 the study’s senior author, Shuji Ogino, MD, PhD, of Dana-Farber, Brigham and Women’s Hospital, and the Harvard School of Public Health. “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.” Before they can be considered definitive, Ogino cautions that the results need to be replicated by other researchers.

Source: Dana-Farber Cancer Institute.