NSAIDs May Improve Survival in Some Colorectal Cancer Patients

The regular use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may improve survival in colorectal cancer (CRC) patients, a recent study showed.

Previous studies have indicated that regular aspirin use may be linked to improved survival in CRC patients. However, little data exists on the timing and types of CRC that would benefit most from taking aspirin and other NSAIDs regularly.
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For their study, the researchers evaluated 2419 patients with incident invasive CRC with BRAF- and KRAS-mutation status, microsatellite instability, and CpG island methylator phenotype. Participants were diagnosed with CRC from 1997 to 2008 and were identified using population-based cancer registries across the United States, Canada, and Australia.

The researchers obtained data directly from patients via detailed epidemiologic questionnaires at baseline and at 5-year follow-up. Median follow-up from diagnosis was 10.8 years.

Survival outcomes were determined through linkage to national death registries. Additionally, Cox proportional hazards regression was used to estimate hazard ratios and 95% CIs for overall survival (OS) and CRC-specific survival.

A total of 381 patients had died during the study period, 100 of which had died from CRC. Results of the analysis indicated that post-diagnostic aspirin-only users demonstrated more favorable OS and CRC-specific survival, especially among those who had initiated aspirin use, compared with patients who did not.

The relationship between any NSAID use post-diagnosis and OS differed significantly depending on patients’ KRAS-mutation status. Specifically, the researchers noted that use of any NSAID after diagnosis was associated with improved OS only in patients with KRAS wild-type tumors, but not in those with KRAS-mutant tumors.

“Among long-term CRC survivors, regular use of NSAIDs after CRC diagnosis was significantly associated with improved survival in individuals with KRAS wild-type tumors,” the researchers concluded.

—Christina Vogt

Reference:

Hua X, Phipps AI, Burnett-Hartman AN, et al. Timing of aspirin and other nonsteroidal anti-inflammatory drug use among patients with colorectal cancer in relation to tumor markers and survival [Published online June 15, 2017]. J Clin Oncol. doi:10.1200/JCO.2017.72.3569.