#1-90E. Can Low-Dose Aspirin Prevent Recurrence in PI3K-Altered Colorectal Cancer? (The New England Journal of Medicine, 2025)

Could the inexpensive, widely available drug aspirin offer a new avenue for preventing colorectal cancer recurrence after resection? This double-blind, randomized, placebo-controlled trial investigated the efficacy of adjuvant aspirin (160 mg daily) in patients with localized colorectal cancer harboring somatic alterations in PI3K pathway genes. The study found that aspirin significantly lowered the 3-year cumulative incidence of recurrence compared to placebo in patients with PIK3CA hotspot mutations (7.7% vs. 14.1%; hazard ratio, 0.49). This finding is clinically significant as it suggests a potential for genomically-guided, low-cost targeted therapy in a substantial subgroup of colorectal cancer patients. However, it is crucial to note that the trial was not powered to assess alternative doses or treatment durations, or to fully characterize subgroup effects, which warrants further investigation.

Reference: MARTLING, A., et al. Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer. The New England Journal of Medicine. 2025, 393(11), pp. 1051-1064. DOI: 10.1056/NEJMoa2504650

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original publication for details.