Aspirin Trialist Collaborative Group
Aspirin and cancer
In 400 BC aspirin was first used by Hippocrates. Acetylsalicylic acid is the fabric name of aspirin, which originates from the bark of a willow tree.
In 1898 the drug was introduced as a painkiller in high dose (500 mg). In the 1970 ’s aspirin became indicated as therapy for cardiovascular prevention. In the trials studying aspirin as indication for cardiovascular prevention it was observed that patients with colorectal cancer taking aspirin have an improved survival compared to patients who do not take aspirin. As a result of this finding, many epidemiological and molecular retrospective studies have been published in the past years(1-3) mainly in the field of colorectal cancer.
…Aspirin and cancer
In 400 BC aspirin was first used by Hippocrates. Acetylsalicylic acid is the fabric name of aspirin, which originates from the bark of a willow tree.
In 1898 the drug was introduced as a painkiller in high dose (500 mg). In the 1970 ’s aspirin became indicated as therapy for cardiovascular prevention. In the trials studying aspirin as indication for cardiovascular prevention it was observed that patients with colorectal cancer taking aspirin have an improved survival compared to patients who do not take aspirin. As a result of this finding, many epidemiological and molecular retrospective studies have been published in the past years(1-3) mainly in the field of colorectal cancer.
Epidemiological studies show a very consistent 40 percent risk reduction of death due to cancer and overall survival.
Now the time has come to verify these data in randomised clinical trials to really assess aspirin as an optional treatment for cancer.
- Chia WK, Ali R, Toh HC. Aspirin as adjuvant therapy for colorectal cancer--reinterpreting paradigms. Nat Rev Clin Oncol 2012; 9(10): 561-70.
- Coyle C, Cafferty FH, Langley RE. Aspirin and Colorectal Cancer Prevention and Treatment: Is It for Everyone? Current Colorectal Cancer Reports 2016.
- Elwood PC, Morgan G, Pickering JE, et al. Aspirin in the Treatment of Cancer: Reductions in Metastatic Spread and in Mortality: A Systematic Review and Meta-Analyses of Published Studies. PLoS One 2016; 11(4): e0152402.
Collaboration
Reasons to collaborate
- All randomised clinical trials involved in this collaboration have a slight difference in design. Dose of aspirin,duration of treatment and inclusion criteria vary. These difference offers a unique opportunity to answer many intriguing questions in subgroups.
- Studies are all in different stages of execution. Trials can mutually give and get advice in the different hurdles that have to be taken to start up such large trials.
- The information gathered by all separate trials is also mutually harmonized and by combining the large amount of available data, this will create the opportunity to pool these data and perform subgroup analysis, for example specific mutation analysis. In this manner, trials do not have to be unnecessarily large and the moment that aspirin can become regular treatment for cancer will be more close.
Reasons to collaborate
- All randomised clinical trials involved in this collaboration have a slight difference in design. Dose of aspirin,duration of treatment and inclusion criteria vary. These difference offers a unique opportunity to answer many intriguing questions in subgroups.
- Studies are all in different stages of execution. Trials can mutually give and get advice in the different hurdles that have to be taken to start up such large trials.
- The information gathered by all separate trials is also mutually harmonized and by combining the large amount of available data, this will create the opportunity to pool these data and perform subgroup analysis, for example specific mutation analysis. In this manner, trials do not have to be unnecessarily large and the moment that aspirin can become regular treatment for cancer will be more close.
G.J. Liefers - ASPIRIN Trial
“If aspirin can become regular treatment for cancer, this will have a large impact on global health”
Contact
For more information please contact one of the PI's of the participating trials or contact the Clinical Research Center of the Leiden University Medical Center at clinicalresearchcenter@lumc.nl.