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Synthesis and Characterization of an Aspirin-fumarate Prodrug that Inhibits NFκB Activity and Breast Cancer Stem Cells
Published on: January 18, 2017
The role of aspirin in cancer prevention
Michael J Thun1, Eric J Jacobs, Carlo Patrono
1Epidemiology Research Program, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, USA. michael.thun@ cancer.org
Insights
Daily low-dose aspirin use shows promise in reducing overall cancer incidence, potentially outweighing bleeding risks. Further research is needed to confirm these cancer-preventive benefits for the general population.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Current clinical guidelines for prophylactic aspirin use primarily focus on cardiovascular benefits versus bleeding risks.
- Aspirin use is known to reduce colorectal cancer risk and adenomatous polyp recurrence, but benefits do not typically outweigh harms in average-risk populations.
- Emerging evidence suggests daily aspirin may reduce the incidence of all cancers combined, even at low doses.
Purpose of the Study:
- To review the mechanism of action of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).
- To evaluate the evidence for aspirin's cardioprotective and cancer-preventive effects.
- To assess whether cancer prevention benefits of aspirin could shift the risk-benefit balance in average-risk populations.
Main Methods:
- Review of secondary analyses from cardiovascular trials.
- Examination of the general mechanism of action for NSAIDs.
- Analysis of evidence on aspirin's effects on cardiovascular health and cancer incidence.
Main Results:
- Low-dose daily aspirin (75-100 mg) may reduce the incidence of all cancers combined.
- Inhibition of platelet activation is hypothesized to mediate both cardioprotective and cancer-preventive effects.
- A 10% reduction in cancer incidence could favor aspirin use in average-risk populations.
Conclusions:
- Daily aspirin use, particularly low-dose, presents a potential strategy for cancer risk reduction.
- The cancer-preventive benefits of aspirin may outweigh bleeding risks in average-risk populations, especially with a significant reduction in cancer incidence.
- Further investigation into the dual cardioprotective and cancer-preventive mechanisms of aspirin is warranted.
Abstract:
Clinical guidelines for prophylactic aspirin use currently only consider the cardiovascular benefits of aspirin, weighed against the potential harm from aspirin-induced bleeding. Daily aspirin use has been convincingly shown to reduce the risk of colorectal cancer and recurrence of adenomatous polyps, but in average-risk populations, these benefits alone do not outweigh harms from aspirin-induced bleeding. Recently published secondary analyses of cardiovascular trials provide the first randomized evidence that daily aspirin use may also reduce the incidence of all cancers combined, even at low doses (75-100 mg daily). This Review considers the general mechanism of action that defines aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) as a class, the specific advantages of aspirin over other NSAIDs for prophylactic use, the current evidence concerning the main health outcomes affected by aspirin use, and the hypothesis that inhibition of platelet activation may mediate both the cardioprotective and cancer-preventive effects of low-dose aspirin. It also considers how even a 10% reduction in overall cancer incidence beginning during the first 10 years of treatment could tip the balance of benefits and risks favourably in average-risk populations.
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