ASCO

GICS 2025: Low-dose aspirin reduces CRC recurrence in patients with PI3K mutations

January 30, 2025

Adjuvant low-dose aspirin significantly reduces recurrence rates in colorectal cancer (CRC) patients with PI3K pathway alterations, suggesting a potential change in clinical practice for approximately one-third of CRC patients.

Study details: The randomized, double-blind, multicenter, placebo-controlled ALASCCA trial (NCT02647099), conducted across 33 hospitals in Sweden, Denmark, Finland, and Norway, included 626 patients with stage I-III rectal cancer or stage II-III colon cancer exhibiting somatic alterations in the PI3K signaling pathway. Participants were randomized to receive either 160 mg of aspirin daily or placebo for three years post surgery.

Results: After three years, hazard ratios (HRs) for time to recurrence comparing aspirin with placebo were 0.49 (95% confidence interval [CI], 0.24-0.98; p = 0.044) in patients with PIK3CA mutations in exon 9/20 (Group A) and 0.42 (95% CI, 0.21-0.83; p = 0.013) in patients with other PI3K pathway alterations (Group B). For disease-free survival, HRs were 0.61 (95% CI, 0.34-1.08; p = 0.091) in Group A and 0.51 (95% CI, 0.29-0.88; p = 0.017) in Group B. Three patients experienced severe aspirin-related adverse events.

Source:

ASCO Gastrointestinal Cancers Symposium. "Low-dose aspirin reduces recurrence rate in colorectal cancer with PI3K pathway alterations." ASCO GICS 2025; Abstract LBA125. Accessed: January 28, 2025. https://meetings.asco.org/2025-asco-gastrointestinal-cancers-symposium/16261?presentation=241158