Aspirin therapy can extend the life of colorectal cancer patients whose tumors carry a mutation in a key gene, but has no effect on patients who lack the mutation, Dana-Farber Cancer Institute scientists report in the Oct. 25 issue of the New England Journal of Medicine.
In a study involving more than 900 patients with colorectal cancer, the researchers found that, for patients whose tumors harbored a mutation in the gene PIK3CA, aspirin use produced a sharp jump in survival: five years after diagnosis, 97 percent of those taking aspirin were still alive, compared to 74 percent of those not using aspirin. By contrast, aspirin had no impact on five-year survival rates among patients 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 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." He cautions that the results need to be replicated by other researchers before they can be considered definitive.
While aspirin is often prescribed for colorectal cancer patients, doctors haven't been able to predict which patients will actually benefit from the treatment. The new finding suggests that the survival benefit is limited to the 20 percent whose tumors have the PIK3CA mutation.
For the remaining patients, aspirin may still be used, but it is likely to be much less effective and can sometimes lead to gastrointestinal ulcers and stomach bleeding.