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Aspirin and COX-2 inhibitor use in patients with stage III colon cancer
Kimmie Ng1, Jeffrey A Meyerhardt2, Andrew T Chan2
1: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (KN, JAM, KS, JAC, RJM, SO, CSF); Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (ATC, ELG, CSF); Alliance Statistics and Data Center, Duke University Medical Center, Durham, NC (DN); Memorial Sloan-Kettering Cancer Center, New York, NY (LBS); Division of Hematology/Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL (ABB); Toledo Community Hospital Oncology Program, Toledo, OH (PLS); Hopital du Sacre-Coeur de Montreal, Universite de Montreal, Quebec, Canada (RW); Edward Cancer Center, Naperville, IL (AH); Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH (RMG); Division of Medical Oncology, University of California at San Francisco, San Francisco, CA (APV); Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (SO); Department of Epidemiology (SO, ELG) and Department of Nutrition (ELG), Harvard School of Public Health, Boston, MA. kng4@partners.org.
Abstract:
We conducted a prospective, observational study of aspirin and COX-2 inhibitor use and survival in stage III colon cancer patients enrolled in an adjuvant chemotherapy trial. Among 799 eligible patients, aspirin use was associated with improved recurrence-free survival (RFS) (multivariable hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.28 to 0.95), disease-free survival (DFS) (HR = 0.68, 95% CI = 0.42 to 1.11), and overall survival (OS) (HR = 0.63, 95% CI = 0.35 to 1.12). Adjusted HRs for DFS and OS censored at five years (in an attempt to minimize misclassification from noncancer death) were 0.61 (95% CI = 0.36 to 1.04) and 0.48 (95% CI = 0.23 to 0.99). Among 843 eligible patients, those who used COX-2 inhibitors had multivariable HRs for RFS, DFS, and OS of 0.53 (95% CI = 0.27 to 1.04), 0.60 (95% CI = 0.33 to 1.08), and 0.50 (95% CI = 0.23 to 1.07), and HRs of 0.47 (95% CI = 0.24 to 0.91) and 0.26 (95% CI = 0.08 to 0.81) for DFS and OS censored at five years. Aspirin and COX-2 inhibitor use may be associated with improved outcomes in stage III colon cancer patients.
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