Concurrent Aspirin Use Is Associated with Improved Outcome in Rectal Cancer Patients Who Undergo Chemoradiation Therapy.

Autor: Farrugia MK; Department of Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA., Long MD; Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA., Mattson DM; Department of Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA., Flaherty LT; Department of Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA., Dong B; Departments of Medicine and Center for Immunotherapy, Roswell Park Cancer Institute, 945 CSC Building, Elm & Carlton Streets, Buffalo, NY 14263, USA., Cortes Gomez E; Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA., Wei L; Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY 14263, USA., Witkiewicz AK; Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA., Yao S; Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14263, USA., Kalinski P; Departments of Medicine and Center for Immunotherapy, Roswell Park Cancer Institute, 945 CSC Building, Elm & Carlton Streets, Buffalo, NY 14263, USA., Singh AK; Department of Radiation Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2021 Jan 08; Vol. 13 (2). Date of Electronic Publication: 2021 Jan 08.
DOI: 10.3390/cancers13020205
Abstrakt: Background: The benefit of aspirin in rectal cancer during chemoradiation therapy (CRT) and the factors affecting its efficacy are not well characterized. We compared the outcomes of rectal patients undergoing neoadjuvant CRT based on aspirin use.
Methods: Patients undergoing CRT for rectal cancer from 2010 to 2018 were evaluated. Aspirin use was determined by medication list prior to treatment. RNA sequencing and subsequent gene set enrichment analysis was performed on surgically resected specimens.
Results: 147 patients underwent neoadjuvant CRT with a median follow-up of 38.2 months. Forty-two patients were taking aspirin prior to CRT. Aspirin users had significantly less local and distant progression, and improved progression-free and overall survival. On RNA-sequencing, neither PI3KCA nor KRAS mutational status were associated with the benefit of aspirin use or tumor downstaging. PTGS2/COX2 expression trended lower in aspirin users, but not with tumor response. Aspirin use was associated with increases of M1 macrophages, plasma cells, CD8+ T cells, and reduction of M2 macrophages in the resected tumor.
Conclusions: Concurrent aspirin use during neoadjuvant CRT was associated with improved local and distant tumor control leading to significantly improved survival. Neither mutations in KRAS or PI3CKA , nor the levels of COX-2 expression at the time of resection of the residual tumor were predictive of these aspirin benefits.
Databáze: MEDLINE
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