Aspirin as adjuvant therapy for colorectal cancer—reinterpreting paradigms

@article{Chia2012AspirinAA,
  title={Aspirin as adjuvant therapy for colorectal cancer—reinterpreting paradigms},
  author={Whay Kuang Chia and Raghib Ali and Han Toh},
  journal={Nature Reviews Clinical Oncology},
  year={2012},
  volume={9},
  pages={561-570}
}
A high-quality body of evidence supports the use of aspirin in reducing sporadic and hereditary adenomatous polyps, and numerous observational studies point to a reduction in colorectal cancer (CRC) risk. However, using aspirin as an adjuvant therapy in established CRC was until recently inconceivable. Now, evidence from both observational and clinical trials of aspirin for other indications suggests that aspirin initiation after (or before) the diagnosis of CRC improves CRC-specific mortality… Expand
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  • C. Fuchs, S. Ogino
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2013
TLDR
A preferential benefit for aspirin is observed in PIK3CA-mutated CRC in a large randomized trial of rofecoxib in patients with stage II/III CRC (VICTOR [Vioxx in Colorectal Cancer Therapy: Definition of Optimal Regime] trial), potentially moving us closer to clinical use of Pik3CA mutation as a predictive biomarker for aspirin use in patientswith CRC. Expand
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TLDR
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TLDR
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TLDR
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TLDR
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TLDR
The potential role that nonsteroidal anti-inflammatory drugs, statins and histamine-2 receptor antagonists may play in improving survival and reducing recurrence in patients with potentially curative colorectal cancer is examined, and in particular focus on their effects on the local and systemic inflammatory response. Expand
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TLDR
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TLDR
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TLDR
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References

SHOWING 1-10 OF 127 REFERENCES
Aspirin Use and Survival After Diagnosis of Colorectal Cancer
TLDR
Findings show that use of aspirin after diagnosis of colorectal cancer is associated with improved survival from the disease, especially among patients with primary tumors that overexpress COX-2. Expand
The utility of Aspirin in dukes C and high risk dukes B colorectal cancer - The ASCOLT study: study protocol for a randomized controlled trial
TLDR
It is hypothesized that Aspirin in patients with dukes C or high risk dukes B colorectal cancer (ASCOLT) can improve survival in this patient population over placebo control, and if indeed found to be beneficial, it will positively impact the lives of many individuals in Asia and globally. Expand
A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas.
TLDR
In this randomized trial, rofecoxib significantly reduced the risk of colorectal adenomas, but also had serious toxicity. Expand
A randomized trial of aspirin to prevent colorectal adenomas.
TLDR
Low-dose aspirin has a moderate chemopreventive effect on adenomas in the large bowel, using generalized linear models to compute risk ratios and 95 percent confidence intervals. Expand
The role of aspirin in cancer prevention
TLDR
The general mechanism of action that defines aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) as a class, the specific advantages of aspirin over other NSAIDs for prophylactic use, the current evidence concerning the main health outcomes affected by aspirin use, and the hypothesis that inhibition of platelet activation may mediate both the cardioprotective and cancer-preventive effects of low-dose aspirin are considered. Expand
Aspirin and folic acid for the prevention of recurrent colorectal adenomas.
TLDR
Aspirin but not folate use was found to reduce the risk of colorectal adenoma recurrence, with evidence that aspirin could have a significant role in preventing the development of advanced lesions. Expand
Adjuvant therapy in colon cancer--what, when and how?
  • I. Chau, D. Cunningham
  • Medicine
  • Annals of oncology : official journal of the European Society for Medical Oncology
  • 2006
TLDR
In stage II colon cancer, adjuvant treatment remains controversial and is not routinely recommended in all medically fit patients by the current American Society of Clinical Oncology guidelines, except several subsets including poorly differentiated histology, T4 lesions, bowel perforation presentation and inadequately sampled lymph nodes. Expand
A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer.
TLDR
Daily use of aspirin is associated with a significant reduction in the incidence of colorectal adenomas in patients with previous coloreCTal cancer. Expand
Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials
TLDR
It is suggested that aspirin might help in treatment of some cancers and provides proof of principle for pharmacological intervention specifically to prevent distant metastasis in patients who developed cancer during trials of daily aspirin versus control. Expand
Phase III randomized trial assessing rofecoxib in the adjuvant setting of colorectal cancer: final results of the VICTOR trial.
  • R. Midgley, C. McConkey, +9 authors D. Kerr
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2010
TLDR
In this study of abbreviated therapy in the adjuvant setting of CRC, rofecoxib did not improve OS or protect from recurrence in unselected patients, and COX-2 expression did not correlate with prognosis overall or predict effectiveness of COx-2 inhibitors. Expand
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