A clinical trial with over 1,000 participants has revealed that a small daily dose of aspirin can reduce the likelihood of colorectal tumors returning after surgery by more than half. This accessible and affordable medication could significantly improve outcomes for cancer survivors carrying certain genetic mutations.
Large-scale genetic screening
Scientists from the Karolinska Institutet and Karolinska University Hospital examined 3,508 individuals with stage I–III rectal cancer or stage II–III colon cancer, identifying 1,103 patients with a PI3K pathway variant. These patients were enrolled in a randomized, double-blind, placebo-controlled trial. Of them, 626 received 160 mg of aspirin daily for three years, while the rest took a placebo.
The project, known as the ALASCCA trial, involved 33 hospitals across Sweden, Norway, Denmark, and Finland. Researchers focused on patients with mutations in the PIK3CA gene and related alterations in PIK3R1 and PTEN, as earlier evidence suggested that aspirin might hinder tumor development in these cases.
“Aspirin is being tested here in a brand-new way—as a precision medicine,” said lead author Anna Martling, professor of Molecular Medicine and Surgery at Karolinska Institutet. “It shows how genetic insights can guide tailored treatments, reducing both suffering and costs.”
Significant reduction in recurrence risk
Results showed that patients with the PIK3 mutation who took aspirin had a 55% lower risk of recurrence compared to those on placebo. Researchers believe aspirin protects against cancer by reducing inflammation, blocking platelet activity, and disrupting tumor growth, which creates an environment less favorable for cancer progression.
Martling explained, “Although researchers have not yet fully mapped out the molecular mechanisms, the data strongly support the biological rationale. “Given that aspirin is cheap, globally available, and well-studied, its potential impact is highly encouraging.”
Previous observational studies had hinted at aspirin’s benefits in lowering colorectal cancer recurrence, but clinical proof had been lacking until now. Doctors could recommend aspirin as a treatment option for cancer survivors with relevant genetic profiles, since patients already use it widely.Research is also underway into its role in other cancers, such as ovarian and gastrointestinal.
Global prevalence of colorectal cancer
Each year, colorectal cancer affects about two million people worldwide, and 15–20% of them carry PI3K pathway mutations, most often in the PIK3CA gene.
According to the trial results, “the estimated three-year cumulative recurrence was 7.7% among aspirin users versus 14.1% with placebo.” Aspirin showed a clear reduction in recurrence among patients with hotspot mutations in PIK3CA exons 9 or 20, with similar benefits seen in those with other alterations in the PI3K pathway.
Read the original article on: New Atlas
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