Anti-cancer mechanism of action of aspirin

  • Research type

    Research Study

  • Full title

    Understanding the anti-cancer mechanism of action of aspirin using samples from the Add-Aspirin trial

  • IRAS ID

    318604

  • Contact name

    Ruth Langley

  • Contact email

    ruth.langley@ucl.ac.uk

  • Sponsor organisation

    Medical Research Council Clinical Trials Unit at UCL

  • Clinicaltrials.gov Identifier

    C569/A24991, AsCaP

  • Duration of Study in the UK

    14 years, 11 months, 30 days

  • Research summary

    Aspirin is known to have anti-cancer effects but the mechanism of action is poorly understood. Similar to other anti-cancer drugs, it has been suggested that specific characteristics of the cancer (genetic mutations) increase the chance of responding to aspirin. In particular it is known that cancers that arise in the context of Lynch Syndrome (hereditary mismatch repair deficiency (MMRd)) are prevented by aspirin and also epidemiological data suggests PIK3CA status effects outcomes with aspirin after radical treatment.

    The Add-Aspirin trial is evaluating whether aspirin use, after treatment for early stage cancers prevents or delays recurrence and improves survival. Currently ~ 10,000 participants have been registered into the trial and over 8000 randomised. This project will focus on the colorectal cancer participants. Since the trial started recruiting molecular characterisation of colorectal cancers after they have been removed surgically has become more common in order to guide further treatment and to understand outcomes and prognosis better. This project will molecularly characterise the tumours form the colorectal cohort for BRAF, KRAS, NRAS, MMRd and PIK3CA so that the trial results can be fully interpreted when they are released.

    In addition, recent data has suggested that the immune system plays an important role in the anti-cancer effects of aspirin. We will therefore study the immune characteristics of the tumours that have been resected and link this to the clinical data from the trial.

    We also propose a small pilot study of up to 150 individuals where we will assess whether similar information can be obtained from a different assay.

  • REC name

    South West - Central Bristol Research Ethics Committee

  • REC reference

    24/SW/0010

  • Date of REC Opinion

    3 Jan 2024

  • REC opinion

    Favourable Opinion