Wiley
CME: Aspirin does not reduce the risk of recurrence or improve survival in adults with breast cancer
July 25, 2024
CME CREDITS - 0.50
POEMS (Patient-Oriented Evidence that Matters)
Clinical question:
Does daily aspirin use reduce the risk of recurrence and improve survival in adults with high-risk nonmetastatic breast cancer?
Bottom line:
This study found no benefit from daily aspirin use compared with placebo in reducing the risk of recurrence or improving survival in adults with high-risk nonmetastatic breast cancer. Although not significant, the risk of disease progression, new primary events, and death were all increased among study participants who were taking aspirin. (LOE = 1b)
Synopsis:
The use of daily aspirin use in adults with breast cancer remains controversial. These investigators identified adults, ages 18 years to 69 years, with a history of ERBB2-negative breast cancer treated with standard therapy. All participants were considered to have high-risk nonmetastatic breast cancer based on hormone receptor status, tumor size, and node involvement. Eligible patients (n = 3,021) randomly received (uncertain allocation concealment) 300 mg aspirin or matching placebo once daily by mouth. Complete follow-up occurred for 98.7% of participants for a median of 34 months.
Using intention-treat analysis at the initial prespecified interim data evaluation, all primary events including death, invasive progression of disease, and new primary events were more numerous in the aspirin group than in the placebo group (141 vs. 112; difference not significant). As a result, the trial safety and monitoring board recommended the study be terminated due to lack of benefit and possible harm of active treatment with aspirin.
David C. Slawson, MD
Reference:
Chen WY, Ballman KV, Partridge AH, et al. Aspirin vs placebo as adjuvant therapy for breast cancer. The Alliance A011502 randomized trial. JAMA 2024;331(20):1714-1721. https://pubmed.ncbi.nlm.nih.gov/38683596/
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