NEJM Audio Summary - Oct 25, 2012 (2)

札幌医大第一内科助教の能正勝彦先生がお名前を連ねている論文。

Excerpted Script
3:18| "Aspirin Use, Tumor PIK3CA Mutation, and Colorectal-Cancer Survival" by Xiaoyun Liao from Dana–Farber Cancer Institute,Boston.
Regular use of aspirin after a diagnosis of colon cancer has been associated with a superior clinical outcome. These authors assessed the effect of aspirin on survival among patients with mutated PIK3CA colorectal cancers might differ from the effect among those with wild-type PIK3CA tumors. Among patients with mutated-PIK3CA colorectal cancers, regular use of aspirin after diagnosis was associated with superior colorectal cancer–specific survival (multivariate hazard ratio for cancer-related death, 0.18) and overall survival (multivariate hazard ratio for death from any cause, 0.54). In contrast, among patients with wild-type PIK3CA, regular use of aspirin after diagnosis was not associated with colorectal cancer–specific survival (multivariate hazard ratio, 0.96) or overall survival (multivariate hazard ratio, 0.94). Regular use of aspirin after diagnosis was associated with longer survival among patients with mutated-PIK3CA colorectal cancer, but not among patients with wild-type PIK3CA cancer. The findings from this molecular pathological epidemiology study suggest that the PIK3CA mutation in colorectal cancer may serve as a predictive molecular biomarker for adjuvant aspirin therapy.
Boris Pasche from University of Alabama, Birmingham writes in editorial that assuming these findings are confirmed in large prospective studies, one may predict that the PIK3CA mutation status of colorectal tumors will become a useful biomarker that may guide adjuvant therapy. Since more than one of six primary colorectal tumors harbors PIK3CA mutations,targeted use of adjuvant aspirin could have a major effect on the treatment of colorectal cancer. Aspirin may well become one of the oldest drugs to be used as a 21st-century targeted therapy. (304 words / 145 sec = 126 wpm)