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ECC 2015: Use of Aspirin Linked to Improved Survival in Gastrointestinal Cancers

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Key Points

  • In total, 30.5% of patients used aspirin prediagnosis, 8.3% were solely postdiagnosis users, and 61.1% had not taken aspirin at all.
  • Patients using aspirin after their diagnosis had a chance of survival twice as high as that of those who did not.
  • The beneficial effect of aspirin use on survival was seen in patients with gastrointestinal tumors after adjusting for potential confounding factors such as sex, age, stage of cancer, surgery, radiotherapy, chemotherapy, and other medical conditions or disorders.

Aspirin improved survival in patients with tumors situated throughout the gastrointestinal tract, results from a large study in the Netherlands showed. This is the first time that survival data from patients with tumors in different gastrointestinal locations have been analyzed at the same time; previously, only one type of cancer, usually colorectal, was studied. The results of the study, involving nearly 14,000 patients, may lead to new insights regarding the use of aspirin in gastrointestinal cancer. These findings were presented (Abstract 2306) at the 2015 European Cancer Congress in Vienna, Austria.

Martine Frouws, MD, of the Leiden University Medical Centre, described how her team analyzed data from 13,715 patients who had been diagnosed with a gastrointestinal cancer between 1998 and 2011. By linking the data to drug-dispensing information from PHARMO, the team was able to show an association between aspirin use after a cancer diagnosis and overall survival; they found there was a significant increase in overall survival among patients who took aspirin compared with those who did not.

Study Findings

In total, 30.5% of patients used aspirin prediagnosis, 8.3% were solely postdiagnosis users, and 61.1% had not taken aspirin at all. The most common sites for tumors were the colon (42.8% of patients), rectum (25.4%), and esophagus (10.2%). Median follow-up for all patients was 48.6 months, with 28% of patients surviving for at least 5 years. Patients using aspirin after their diagnosis had a chance of survival twice as high as that of those who did not. The beneficial effect of aspirin use on survival was seen in patients with gastrointestinal tumors after adjusting for potential confounding factors such as sex, age, stage of cancer, surgery, radiotherapy, chemotherapy, and other medical conditions or disorders.

“In most observational studies an ‘intention to treat’ method is used for analyzing aspirin’s effect. In this study we analyzed each separate prescription per patient, and therefore we were able to achieve a more exact estimate of the effect of aspirin on cancer survival. Now we would like to analyze tumor material from these patients to try and discover which ones would benefit from aspirin treatment. Through studying the characteristics of tumors in patients where aspirin was beneficial, we should be able to identify patients who could profit from such treatment in the future,” Dr. Frouws explained.

At present, a multicenter, randomized, placebo-controlled trial is investigating the effect of a daily dose of 80 mg of aspirin on overall survival of elderly patients with colon cancer in the Netherlands. The researchers hope that they will then be able to expand the trial to include further sites in the gastrointestinal tract and provide convincing proof that more patients will benefit from aspirin treatment. “Given that aspirin is a cheap, off-patent drug with relatively few side effects, this will have a great impact on healthcare systems, as well as patients,” said Dr. Frouws.

“Medical research is focusing more and more on personalized medicine,” Dr. Frouws said, “but many personalized treatments are expensive and only useful in small populations. We believe that our research shows quite the opposite—it demonstrates the considerable benefit of a cheap, well-established and easily obtainable drug in a larger group of patients, while still targeting the treatment to a specific individual.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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