Treatment Outcomes in Stage III Colon Cancer Appear Better in Aspirin, COX-2 Inhibitor Users

CancerConnect News:   According to the results of a study recently reported in the Journal of the National Cancer Institute, patients with stage III colon cancer who take aspirin or other agents that inhibit cyclooxygenase-2 near the time of adjuvant chemotherapy appear to have a lower risk of cancer recurrence.

It has long been suggested that aspirin and COX-2 inhibitor use may be associated with improved outcomes in the management of early stage colon cancer patients based on analyses of observational clinical studies.

In the current study, investigators analyzed data from patients enrolled in a Cancer and Leukemia Group B study that previously compared different chemotherapy treatment regimens for stage III colon cancer.  Overall, 9.4% of patients with relevant data were aspirin users and 7.0% were users of COX-2 inhibitors. Users were defined as individuals reporting to use both during and 6 months after chemotherapy.

With a median follow-up of 6.5 years, users relative to nonusers of either COX-2 inhibitors or aspirin were more likely to delay cancer recurrence and experience longer survival. Analyses also suggested a possible dose-response relationship for aspirin, whereby benefit increased with weekly dose. Neither medication class was associated with an increased risk of cardiovascular events or other side effects.

While the exact dose and duration of aspirin or COX-2 inhibitors required for a potential protective effect in the management of colon cancer remains unclear, this analysis of colon cancer patients enrolled in a chemotherapy clinical trial supports a benefit for aspirin use in individuals with colorectal cancer.

CALGB 80702 and ASCOLT are two ongoing trials currently being performed which evaluate the role of celecoxib and aspirin, respectively, in colon cancer. Individuals undergoing chemotherapy for the treatment of colon cancer should discuss the potential risks and benefits of taking concomitant aspirin with their treating physician. Many individuals can certainly benefit from daily aspirin for other reasons; however, some individuals­­­, particularly those with various gastrointestinal conditions, may have their condition worsened with aspirin. Patients should always make their doctor aware of any non-prescribed medicines or supplements they are taking.

Reference:  Ng K, Meyerhardt J, Chan A, et al. Aspirin and COX-2 Inhibitor Use in Patients With Stage III Colon Cancer. Journal of National Cancer Institute. (2015) 107 (1): dju345 doi: 10.1093/jnci/dju345.

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