Adjuvant aspirin therapy and colorectal cancer survival

Mené sur 1 550 patients atteints d'un cancer colorectal (âge médian : 57 ans ; durée médiane de suivi : 59,2 mois), cet essai international de phase III (11 pays ou territoires de l'Asie-Pacifique ou du Moyen-Orient) évalue l'intérêt, du point de vue de la survie sans maladie et de la toxicité, de l'aspirine après un traitement adjuvant standard

Résumé en anglais

Although aspirin has a well established role in the primary chemoprevention of colorectal cancer, its effect on colorectal cancer survival has been limited to conflicting observational studies and sparse interventional data from follow-up of trials designed to evaluate non-cancer outcomes.1 In The Lancet Gastroenterology & Hepatology, John W K Chia and colleagues2 report the first randomised, placebo-controlled, phase 3 trial (ASCOLT) investigating the effect of adjuvant aspirin for colorectal cancer. 1550 participants with resected non-metastatic colorectal cancer from 11 countries or territories in Asia-Pacific and the Middle East were randomly assigned to receive daily aspirin 200 mg or placebo for 3 years. No significant differences were observed in 5-year disease-free survival or overall survival between the aspirin and placebo groups, with hazard ratios (HRs) of 0·91 (95% CI 0·73–1·13) for disease-free survival and 0·75 (0·53–1·07) for overall survival. The findings and methodology have important implications for ongoing trials and future studies.