Aspirin has selective benefit in colorectal cancer
Patients with gene mutation appear to gain advantage from drug
By Nathan Seppa
The mystery of why aspirin helps some colorectal cancer patients but not others may be partially solved. A new study finds that the drug seems to extend survival in patients whose tumors harbor a specific genetic mutation, while patients lacking the mutation get no survival advantage from regularly taking the pills.
The study, in the Oct. 25 New England Journal of Medicine, may lead to standardized testing of colorectal cancer patients for the mutation, in a gene called PIK3CA, to see who would benefit from aspirin use.
“We may be witnessing a game changer,” says Boris Pasche, an oncologist at the University of Alabama at Birmingham who wasn’t part of the study team. “I wouldn’t be surprised to see labs beginning to test for this mutation quickly.”
The study will need to be validated in a randomized clinical trial before a PIK3CA test becomes part of treatment guidelines, Pasche says. Roughly 15 to 20 percent of patients with colorectal cancer have the mutation.