Can Aspirin Improve Cancer Outcomes?

The use of aspirin is well tolerated following cancer treatment and could potentially offer a viable therapy in improving cancer outcomes, according to a study published in The Lancet.

The researchers of this study noted that preclinical, epidemiological, and randomized data all suggest that aspirin might prevent tumor development and metastasis, leading to reduced cancer mortality, particularly among patients with gastro-esophageal and colorectal cancer. While randomized trials evaluating the efficacy of aspirin use after primary radical therapy are ongoing, this study, according to the researchers sought to investigate the “feasibility analysis of the run-in phase of the Add-Aspirin trial to address concerns about toxicity, particularly bleeding after radical treatment for gastro-esophageal cancer.”

The Add-Aspirin protocol study comprised three randomized control trials recruited over two years (October, 2015, to October, 2017) that assessed the effects of daily aspirin on cancer recurrence and survival in four tumor cohorts: gastro-esophageal (n=115), colorectal (n=950), breast, (1,675), and prostate (754). Overall, the researchers proceeded with evaluating 2,719 (85%) of participants, who proceeded to an open-label run-in phase where they were administered 100 mg of aspirin daily over a duration of 8 weeks. Subsequently, they conducted a double-blind randomization which included (for patients under the age of 75) aspirin 300 mg, aspirin 100 mg, or matched placebo in 1:1:1 ration, and for patients aged 75 and older, aspirin 100 mg or matched placebo in a 2:1 ratio.

Aspirin Exhibits Cancer-Fighting Potential

According to the results of the trial, end of run-in data were available on 2,253 patients showed that 2,148 (95%) of the participants took six or seven tablets per week with 11 (0·5%) of reporting grade 3 toxicity during the run-in period, with no upper gastrointestinal bleeding (any grade) in the gastro-esophageal cancer cohort. They observed that the most frequent grade 1–2 toxicity overall was dyspepsia (246 [11%] of 2,253 participants).

“Aspirin is well-tolerated after radical cancer therapy,” the study authors wrote in their conclusion. “Toxicity has been low and there is no evidence of a difference in adherence, acceptance of randomization, or toxicity between the different cancer cohorts. Trial recruitment continues to determine whether aspirin could offer a potential low cost and well tolerated therapy to improve cancer outcomes.”