May 26, 2024

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Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients

Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients



Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients

Colorectal cancer is the third most common cancer and the fourth leading cause of cancer-related deaths globally. Previous studies have suggested that aspirin plays an important role in preventing colorectal cancer, potentially reducing the risk of developing the disease. However, the underlying mechanisms by which aspirin inhibits lymph node and distant metastases have not been clear.

A recent study published in Cancer suggests that the use of aspirin by colorectal cancer patients may be associated with lower tumor grades and lymph node metastases, as well as higher tumor infiltration.

This indicates that aspirin may play a role in promoting immune surveillance in colorectal cancer, helping the body’s immune system to timely identify and clear mutated cells (including tumor cells) and viral infections.

 

Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients

 

 

Researchers included 238 colorectal cancer patients who underwent surgery between 2015 and 2019 (sourced from the retrospective METACCRE cohort and the prospective METACCRE cohort) in the study. They conducted immunohistochemical examinations on them (including MLH1, PMS2, MSH2, and MSH6), as well as mutation analysis [including BRAF (exon 15), KRAS (exons 2, 3, and 4), and NRAS (exons 2, 3, and 4)]. They also analyzed the immune infiltration in the surrounding healthy mucosa of some subgroup patients with colorectal cancer to understand the effect of aspirin on the mucosal immune microenvironment.

A total of 31 (13%) patients were defined as aspirin users. Regarding the impact of aspirin use on the staging and microenvironment of colorectal cancer, the results showed (aspirin users vs. non-users):

– T staging and primary cancer site: No significant difference was observed;
– Tumor grade: Patients who took aspirin had a lower tumor grade (P=0.02), especially in patients with BRAF-mutant colorectal cancer (P=0.029);
– Lymph node metastasis rate: Patients who took aspirin had a lower rate (P=0.008) and fewer metastatic lymph nodes (P=0.01);
– Tumor infiltration: Patients who took aspirin had higher infiltration (P=0.02).

Regarding the effect of aspirin use on the systemic immune response of colorectal cancer, researchers found that in terms of the neutrophil-to-lymphocyte ratio (NLR), patients who took aspirin had a lower NLR (P=0.042), especially in patients with mismatch repair gene defects (P=0.008) and BRAF mutations (P=0.009).

Patients with right-sided colon cancer used aspirin more frequently than those with left-sided colon cancer (P=0.032), and patients with right-sided colon cancer had a lower tumor grade (P=0.025), a lower rate of lymph node metastasis (P=0.036), and fewer metastatic lymph nodes (P=0.008).

Furthermore, in primary colorectal cancer cells and selected cell lines, aspirin treatment led to an increase in CD80 mRNA expression (P=0.001). In the healthy mucosa surrounding rectal cancer, patients who used aspirin had a higher proportion of CD8/CD3 (P=0.027) and epithelial cells expressing CD80 (P=0.034).

In conclusion, the results of this study suggest that the use of aspirin by colorectal cancer patients may be associated with lower tumor grades and lymph node metastases, as well as higher tumor infiltration, with these effects being more pronounced in the right colon. This study suggests that aspirin may play a role in promoting immune surveillance in colorectal cancer.

Aspirin: Study Finds Greater Benefits for These Colorectal Cancer Patients

Reference:

[1] Simoni O, Scarpa M, Castagliuolo I, et al. IMMUNOREACT 7: Regular aspirin use is associated with immune surveillance activation in colorectal cancer. Cancer. 2024 Apr 22. doi: 10.1002/cncr.35297. Epub ahead of print. PMID: 38644692.

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