Aspirin Back in the News!


hero symbol
In August, September, and October 2009, we wrote about aspirin in the Fight Colorectal Cancer Blog. We wrote about how the use of aspirin could reduce the risk of new polyps, how it might prevent Lynch syndrome cancers, and how it could actually save more lives after colon cancer treatment. While the studies we reported on eight years ago were fascinating and provided solid insight into the potential role of aspirin in colorectal cancer care - we have even more information now that proves how scientific inquiry and advancement can continue to improve the lives of many patients and survivors.

What is Aspirin?

Aspirin falls into the category of nonsteroidal anti-inflammatory drugs (NSAIDs). So does ibuprofen, naproxen, and others; however, these work slightly differently than aspirin. For many years, low-dose aspirin has been prescribed to individuals at high risk of heart attack, and NSAIDs as a whole are often taken to ease pain, headaches, arthritis, and other conditions. More recently, studies have shown some benefit for cancer patients.

Biomarkers and NSAIDs

A study entitled Timing of Aspirin and Other Nonsteroidal Anti-Inflammatory Drug Use Among Patients With Colorectal Cancer in Relation to Tumor Markers and Survival was published the August 2017 Journal of Clinical Oncology detailing the results of a new observational study on NSAIDs. Previous research has linked longer survival to the regular use of NSAIDs. The present study dives in a bit deeper. Researchers worked with data from close to 2,500 patients in a colon cancer registry that collects information about lifestyle, family history and additional medical information. The data includes colorectal cancer patients in Australia, Canada and the United States. After identifying patients who had lived at a minimum of 5 years post diagnosis, the study team surveyed the selected individuals to learn about their reported use of NSAIDs, like aspirin, and others. They then followed the individuals for a subsequent 5 year time frame. The results from this piece of the study were quite similar to studies of the past:  regular use of NSAID was linked to better overall survival.

Biomarkers and Aspirin

An additional part of the study involved researchers looking at the tumor types (or biomarker types) of the patients they surveyed from the registry. They aimed to identify whether or not there was a difference in aspirin use among the various biomarkers:  BRAF, KRAS and MSI. Turns out, individuals with KRAS-wild type (patients without a KRAS mutation) had a significantly longer survival with the regular use of NSAIDs, but no benefit of aspirin was found for patients with a KRAS mutation. Approximately 70% of CRC patients have tumors that are KRAS-wild type. The remaining  30% have tumors with a KRAS mutation.

How does this information affect colorectal cancer patients and survivors?

According to Dr. Dennis Ahnen, who was one of the co-authors of the paper,
“This data confirms the previously reported survival benefit of aspirin therapy for patients with colorectal cancer and adds to the strong evidence that aspirin can beneficially impact many stages in the progression from normal colonic mucosa to polyps, to cancer and cancer treatment."
Dr. Ahnen continued,
"Although understanding the risks of aspirin (GI ulcers and bleeding, hemorrhagic stroke) is important, I believe patients who are at high risk for colorectal cancer and low risk for the complications of aspirin should be offered aspirin chemoprevention, and those with established colorectal cancer should discuss adding aspirin to their treatment regimen with their provider.  In my opinion, the intriguing possibility that only patients with KRAS wild-type tumors are benefited by aspirin requires confirmation. It may well be that aspirin is more effective (or only effective) in defined molecular subtypes of colorectal cancers.”

Do You Know your Biomarker Status?

We know the biomarker status of patients is important in treatment decision making. For example, some patients expressing a particular biomarker may not respond to a certain treatment, while others will. Or, some patients will experience differences in side effects and toxicities as a result of treatment. Read MoreBiomarkers & Biomarker Testing The present study emphasizes the importance of knowing your biomarkers since this could help in survivorship and surveillance care. A long life after diagnosis is something that all colorectal cancer patients want. While there are clear lifestyle habits to adopt (like healthy eating and regular exercise), this study indicates that, with more research, there could be additional options for survivors to increase their longevity.

ALWAYS talk to your doctor first!

There are some limitations to the study - for example, it was an observational study and relied on self-reported data from patients regarding their NSAID use. While the results of the study are intriguing, they do not change any current recommendations. Therefore it is important to talk to your doctor prior to beginning a regular NSAID regimen and discuss potential side effects like increased risk of ulcers of the stomach and duodenum, stroke, internal bleeding, and others.

Get More Resources and Research News

Fight Colorectal Cancer will continue to monitor the research news impacting patients and report it to you. To be the first to know, sign up for our emails and we'll email you the highlights each month. Also, check out our resource library for free downloads, videos, fact sheets and more on topics related to colorectal cancer.

One thought on “Aspirin Back in the News!

  1. I have KRAS Wild Type Stage IV MCC and November 1st, 2017 it will be 11 years since I was diagnosed. I take a baby aspirin daily.

Comments are closed.