Daily aspirin use improves survival among patients with mutated-PIK3CA colorectal cancer, according to the results of a study published in the New England Journal of Medicine.

Colorectal cancer remains the second leading cause of cancer-related death in the United States. The phosphatidylinositol 3-kinase (PI3K) signaling pathway plays a significant role in carcinogenesis. Approximately 15 to 20 percent of colorectal cancers carry a PIK3CA mutation. There is some evidence that aspirin may suppress cancer growth by blocking the PI3K pathway.

Researchers from Massachusetts analyzed data from 964 patients from two large prospective cohort studies—the Nurses' Health Study and the Health Professionals Follow-up Study. They noted the patients’ PIK3CA mutation status and aspiring use after being diagnosed and found that those with the mutation gained a survival benefit with daily aspirin use. Among patients with PIK3CA mutations, five years after diagnosis, 97 percent of those taking daily aspirin were still alive, compared to 74 percent of those not taking aspirin. In contrast, aspirin had no impact on five-year survival rates among patients without the mutation.

The researchers concluded that daily aspirin use after diagnosis was associated with longer survival among patients with PIK3CA mutations, but not those without the mutation. These results suggest that the PIK3CA mutation could serve as a predictive biomarker for aspirin therapy. Larger studies will be needed to verify these results—but for now it appears that patients with the PIK3CA mutation might benefit from aspirin use. Other patients may choose to use aspirin as well; however, it could be less effective and sometimes leads to gastrointestinal ulcers and stomach bleeding.

Reference:

Liao X, Lochhead P, Nishihara R, et al. Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival. New England Journal of Medicine. 2012; 367: 1596-1606.

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