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Can Aspirin Prevent Bowel Cancer?
This clinical trial looked at whether a low dose of aspirin could help prevent bowel cancer from coming back after people had surgery for stage 1–3 tumours with specific mutations. Participants were grouped according to the tumour mutations present. Group A was the primary focus of the trial and included people who had a tumour with a common and specific mutation in the PIK3CA gene. Group B included people who had tumours with other mutations in the PIK3CA, PIK3R1, and PTEN genes. These genes are involved in the PI3K pathway - a cell signalling pathway that helps regulate cell growth. When faulty, it can contribute to uncontrolled cell division and tumour growth.
A total of 626 participants from four Nordic countries took part. Within 12 weeks of surgery, half of the participants received daily aspirin and half received a placebo, in addition to standard clinical treatment. After 3 years of follow-up, participants in Group A who took aspirin had a significantly lower rate of cancer recurrence (7.7%) compared to those who took the placebo (14.1%). A similar benefit was seen in Group B, though this was a secondary finding. Serious side effects were uncommon but slightly more frequent in the aspirin group compared to the placebo group. This trial provides evidence that taking aspirin may help reduce cancer recurrence in patients with certain tumour mutations. While more research is needed to determine the best dose and duration, and whether factors like weight and sex affect outcomes, aspirin could be a cost-effective and accessible additional treatment for bowel cancer.