Significantly lower incidence of colorectal cancer recurrence seen for patients with somatic alterations in PI3K pathway genes<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b>
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FRIDAY, Sept. 19, 2025 (HealthDay News) — Aspirin is associated with a lower incidence of colorectal cancer (CRC) recurrence among certain patients with rectal or colon cancer with somatic alterations in PI3K pathway genes, according to a study published online Sept. 17 in the New England Journal of Medicine<\/em>.<\/p>\n Anna Martling, M.D., Ph.D., from Karolinska Institutet in Stockholm, and colleagues conducted a randomized trial involving patients with stage I, II, or III rectal cancer or stage II or III colon cancer with somatic alterations in PI3K pathway genes (prespecified PIK3CA<\/em> hotspot mutations in exon 9 or 20 [group A alterations] and those with other moderate- or high-impact somatic variants in PIK3CA<\/em>, PIK3R1<\/em>, or PTEN<\/em> [group B alterations]).<\/p>\n Of 515 patients with group A alterations and 588 with group B alterations, 314 and 312, respectively, were randomly assigned to receive 160 mg of aspirin or matched placebo once daily for three years. The researchers found that the estimated three-year cumulative incidence of recurrence was 7.7 and 14.1 percent with aspirin and placebo, respectively, among patients with group A alterations and 7.7 and 16.8 percent among patients with group B alterations (hazard ratios, 0.49 [95 percent confidence interval (CI), 0.24 to 0.98] and 0.42 [95 percent CI, 0.21 to 0.83], respectively). The estimated three-year disease-free survival was 88.5 and 81.4 percent with aspirin and placebo, respectively, among patients with group A alterations (hazard ratio, 0.61 [95 percent CI, 0.34 to 1.08]) and 89.1 and 78.7 percent among patients with group B alterations (hazard ratio, 0.51 [95 percent CI, 0.29 to 0.88]).<\/p>\n “The findings strongly support the biological rationale and suggest that the treatment may be particularly effective in genetically defined subgroups of patients,” Martling said in a statement.<\/p>\n Several authors disclosed ties to the pharmaceutical and biomedical industries.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n Editorial (subscription or payment may be required)<\/a><\/p>\n