Aspirin May Help Prevent Cancer in Patients with Barrett’s Esophagus
Although aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce cancer mortality by 20%, exactly why these drugs reduce the number of cancer incidences and deaths is not known. Now, a small longitudinal study of 13 patients with Barrett’s esophagus is showing that NSAIDs may fight against the development of cancer by reducing the prevalence of somatic genomic abnormalities (SGA) over time. The study was published in PLOS Genetics.
Barrett’s esophagus is thought to develop as the result of chronic gastroesophageal reflux disease and can increase the risk of esophageal adenocarcinoma. In this study, 13 patients with Barrett’s esophagus were given periodic endoscopic biopsies—10 to 20 biopsies per individual—over 6.4 to 19 years of follow-up to measure chromosomes that were getting deleted or copied. Over time, the researchers found that the rate of accumulation of genomic abnormalities decreased when most of the patients started taking NSAIDs. In all, NSAIDs were associated with a reduced rate of prevalence of SGAs in 11 of the 13 individuals.
“Our data [show] that overall NSAID use is associated with an approximately 10-fold reduction in the rate of acquisition of SGAs and expansion of those lineages to detectable levels, from 7.8 SGAs per genome per year (95% support interval = 7.1–8.6) to 0.6 SGAs per genome per year. However, this was only clear in 11 of our 13 individuals (with nonoverlapping 95% support intervals in 8 of those 11). In the two individuals who stopped NSAID use during follow-up, the data [do] not show a significant reduction in SGA rate by NSAIDs,” wrote the researchers.
Providing Clinical Benefit
Although NSAIDs affect individuals differently and larger studies will be needed to determine the specific factors involved in providing a cancer prevention benefit, “These findings suggest that NSAIDs may prevent cancer by reducing the accumulation of genomic abnormalities over time and that detection of stable vs unstable genomes may be used in the clinic to help manage treatment options in Barrett’s esophagus,” concluded the researchers.
The National Institutes of Health and the American Cancer Society provided funding for this research. The authors reported no potential conflicts of interest.
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®.
