Aspirin Lowers Colorectal Cancer Recurrence Risk in Patients with P13K Mutations

March 2025

A phase 3 trial presented at the 2025 Gastrointestinal Cancers Symposium showed that three years of aspirin use significantly reduced the risk of recurrence in colorectal cancer patients with PIK3CA mutations.

What is PIK3CA?

PIK3CA is a gene that is commonly mutated (changed) in many types of cancer and in 10-20% of colorectal cancers. A PIK3CA mutation drives the growth of cells.

The trial

The ALASCCA trial found a 51% decrease in recurrence risk among patients with subtypes of PIK3CA mutations (exon 9/20) and a 58% decrease for those with PIK3R1/PTEN/ other PIK3CA alterations after three years of aspirin use. The study also indicated that aspirin’s benefits may extend beyond PIK3CA mutations, potentially benefiting up to 40% of colorectal cancer patients.

Although some side effects were reported, researchers emphasized that they were consistent with those typically associated with this well-known medication.

These findings highlight the potential to repurpose aspirin—an affordable and widely accessible drug—for colorectal cancer treatment while underscoring the importance of genomic testing in identifying who may benefit from aspirin, particularly individuals with specific PIK3CA alterations.