Examining the impact of regular aspirin use and PIK3CA mutations on survival in stage 2 colon cancer

• DOI: 10.1111/imj.13312
• Publication Date: 2016-11-12T09:47:31Z
• Authors: Caitlin Murphy; Natalie Turner; Hui‐Li Wong; Mathu Sinnathamby; Jeanne Tie; Belinda Lee; Jayesh Desai; Iain Skinner; Michael Christie; Ryan Hutchinson; Sebastian Lunke; Paul Waring; Peter Gibbs; Ben Tran
• Keywords: Adult; Male; Databases, Factual; Class I Phosphatidylinositol 3-Kinases; 610; Phosphatidylinositol 3-Kinases; 03 medical and health sciences; 0302 clinical medicine; 616; Humans; Genetic Testing; Prospective Studies; Aged; Aged, 80 and over; Aspirin; Anti-Inflammatory Agents, Non-Steroidal; Australia; High-Throughput Nucleotide Sequencing; Middle Aged; Survival Analysis; 3. Good health; Colonic Neoplasms; Multivariate Analysis; Mutation; Female

Data suggest aspirin improves survival in colorectal cancer (CRC) harbouring PIK3CA mutations. The impact of is thought predominantly to be through an anti-inflammatory effect. aim this study explore the effect use on a real-world cohort stage 2 colon (CC) patients.A prospective CRC database identified patients diagnosed with CC between 2000 and 2011. mutation status was determined by next generation sequencing. Neutrophil-lymphocyte ratio greater than 5 at diagnosis represented systemic inflammation. Chart review used record regular diagnosis. Clinico-pathological features data were available. Survival analyses Cox proportional hazards method.Of 488 CC, 95 users 70 had Aspirin more likely older (median: 76.4 years vs 68.3 years, P < 0.001), less fit (American Society Anaesthetists Score 3-4: 58% 31%, 0.001) have inflammation (neutrophil-lymphocyte > 5: 39% 27%, = 0.027). Regular did not significantly improve recurrence-free survival. In mutated group, there trend towards improved (hazard ratio: 0.45, 0.42).Our demonstrate significant advantage from CC. 'real-world' nature our subsequent uncontrolled differences age fitness are contributed result. Defining true requires randomised clinical trials.