Aspirin: Scientist crack how painkiller might stop cancers from spreading - BBC News

Link to the BBC News article

The BBC News article linked above discusses the ALASCCA trial which evaluated aspirin after colorectal cancer resection in patients whose tumour had alterations in the P13K signalling pathway. Participants (n=626) were stratified into 2 groups. Group A: PIK3CA mutations in exon 9 and/or 20 and Group B: other PI3K pathway driver alterations (PIK3CA mutations outside exon 9/20, PIK3R1, or PTEN) and randomised to aspirin or placebo. The primary outcome measure was time to recurrence after 3 years of follow-up: Group A hazard ratio (HR) 0.49 (95% CI; 0.24-0.98; p=0.044) and Group B 0.42 (95% CI; 0.21-0.83; p=0.013) with similar sized effects for disease free survival in both groups. 

 

While the Add-Aspirin colorectal trial is not restricted to those with P13K signalling alterations genetic testing of tumour blocks is underway for PIK3CA mutations (exon 9 and 20). The Add-Aspirin Colorectal Trial Management Group (TMG) supported by participant representatives have discussed these results and agreed:

 

1. The trial currently should continue as planned noting potential wider benefits of aspirin beyond metastasis prevention including reduction of secondary cancers and cardiovascular benefits. Participants therefore should be encouraged to stay on treatment and complete follow-up.
2. Tumour block collection is a priority, and the molecular analysis should continue (and be extended to include the Group B patients if feasible) to validate the ALASCCA results
3. Maximising the completeness of the trial data is a key focus

 

The ALASSCA results may lead to questions from participants. If you have any queries, please contact the team at mrcctu.add-aspirin@ucl.ac.uk.  You may also have seen recent news coverage about work from Cambridge University which has identified a novel mechanism explaining how aspirin can prevent metastases (visit the Nature article webpage). This exciting discovery is likely to provide further information about who will benefit from aspirin.