Aspirin use following adjuvant therapy does not improve disease outcomes in colorectal cancer patients

A large phase 3 trial (ASCOLT) found that daily aspirin use for 3 years after standard adjuvant therapy (treatment given to patients following surgery) did not improve disease-free survival in an unselected population of colorectal cancer patients. Conducted across 11 countries with 1,550 participants, the study showed no statistically significant difference in 5-year DFS between the aspirin and placebo groups (77% vs. 74.8%). 

Disease-free survival: refers to the length of time after treatment during which a person remains free from any signs or symptoms of cancer. 

Although aspirin was well tolerated, with similar rates of adverse events and no treatment-related deaths, researchers concluded that aspirin should not be used as secondary prevention in the general colorectal cancer population post-treatment. 

However, previous findings (e.g., the ALASCCA trial) suggest aspirin may significantly benefit patients with PIK3CA mutations, reducing recurrence risk by 50%. This highlights the potential for biomarker-guided use of aspirin in future colorectal cancer therapies.