Low-dose aspirin in high-risk individuals with screen-detected subsolid lung nodules: a randomized phase-II trial

Mené entre 2014 et 2017 sur 109 patients présentant des nodules pulmonaires non solides détectés par tomodensitométrie (âge moyen : 64,6 ans ; 43,8 % d'hommes ; 67,3 % de fumeurs), cet essai de phase IIb évalue l'efficacité, du point de vue de l'évolution de la taille des nodules, d'un traitement par faibles doses d'aspirine pendant 12 mois

Résumé en anglais

Lung cancer screening by helical low-dose computed tomography (ld-CT) detects non-solid nodules that may be lung adenocarcinoma precursors. Aspirin’s anti-inflammatory properties make it an attractive target for prevention of multiple cancers, including lung cancer. Therefore, we conducted a phase IIb trial (NCT02169271) to study the efficacy of low-dose aspirin to reduce the size of subsolid lung nodules (SSNs). A total of 98 current or former smokers (67.3% current) undergoing annual ld-CT screening with persistent SSNs were randomly assigned to receive aspirin 100 mg/day or placebo for one year. There was no difference in change after 12 months of treatment between the two study arms in the sum of the longest diameters of target nodules (-0.12 mm [SD = 1.55] and +0.30 mm [SD = 2.54] in the placebo and aspirin arm, respectively, two-sided p = 0.33 primary endpoint), nor in subgroup analyses by individual characteristics or nodule type. One year of low-dose aspirin did not show any effect on lung SSNs. SSNs regression may not be the proper target for aspirin and/or longer duration may be needed to see SSNs modifications.