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Biological markers

Potential biomarker for aspirin use in colorectal cancer therapy

Patients with colorectal cancer with mutated PIK3CA, identified from two large observational cohorts, had increased cancer-specific and overall survival if they used aspirin regularly after diagnosis compared to non-users. No effect of aspirin was seen in patients with wild-type PIK3CA. Mutated PIK3CA might be a useful biomarker to select patients who would benefit from adjuvant aspirin therapy.

Key Points

  • Patients with colorectal cancer with mutated PIK3CA, identified from two large observational cohorts, had increased cancer-specific and overall survival if they used aspirin regularly after diagnosis compared to non-users

  • Randomized trials specifically designed to assess the role of aspirin in the treatment of cancer are needed and to assess the potential value of PIK3CA as a biomarker of aspirin response

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Figure 1: Cyclooxygenases convert arachidonic acid to biologically active prostanoids.

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Acknowledgements

P. M. Rothwell is partly funded by Senior Investigator Awards from the National Institute of Health Research (NIHR) and the Wellcome Trust.

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Correspondence to Peter M. Rothwell.

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Competing interests

P. M. Rothwell and R. E. Langley have received an honorarium from the Aspirin Foundation for speaking at a conference. P. M. Rothwell has also received honoraria for talks, advisory boards and clinical trial committees from several pharmaceutical companies with an interest in antiplatelet agents, including Astra-Zeneca, Bayer, Boehringer Ingelheim, Sanofi-BMS and Servier, and is on the Executive Committee of the ASCOLT and ARRIVE trials.

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Langley, R., Rothwell, P. Potential biomarker for aspirin use in colorectal cancer therapy. Nat Rev Clin Oncol 10, 8–10 (2013). https://doi.org/10.1038/nrclinonc.2012.216

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