《美国临床肿瘤杂志》新发表研究发现指出只有特定类型直肠癌患者才能从阿司匹林治疗中受益。研究果表明这种类型肿瘤患者在使用阿司匹林能够显著延长生存期并降低癌症复发风险。对于他类型直肠癌患者阿司匹林并没有显示出类似治疗效果。这发现为肿瘤治疗领域带了新突破有望为医生在制定直肠癌治疗方案提供更为精确指导。研究果或为未个性化治疗提供了新方向并为生物标志物筛选提供了参考。
美国《临床肿瘤杂志》6月15日在线先发
/doi/full/10.1200/JCO..72.3569
在结直肠癌患者中阿司匹林和其它非甾体抗炎药物的使用时机与肿瘤标志物、生存期的相关
性
目的
常规使用阿司匹林可延长结直肠癌患者的生存期，但阿司匹林和其它非甾体抗炎药物的使用时机与生存期的相关性、何种结直肠癌亚型使用这类药物生存期最受益尚不清楚。
患者与方法
总体上，在美国、加拿大和澳大利亚，从以人群为基础的癌症登记处甄别出2419名自1997-诊断出的、年龄18-74岁的新发浸润性结直肠癌患者。在研究入组和随访5年时进行了详细的流行病学调查问卷。通过国家死亡登记处完成了生存结果的调查。还对BRAF和KRAS突变情况、微卫星不稳定性、CpG岛甲基化表型进行了评估。采用Cox比例风险回归，对总生存期（OS）、结直肠癌特异性生存期的风险比（HR）和95%CI进行了估算。
结果
自诊断以来中位随访10.8年后，观察到381名死亡（100名死于结直肠癌）。与未使用阿司匹林者相比，诊断后仅使用阿司匹林者，总生存期（HR，0.75；95%CI，0.59-0.95）和结直肠癌特异性生存期（HR，0.44；95%CI，0.25-0.71）更长，诊断后开始使用阿司匹林者尤其如此（总生存期：HR，0.64；95%CI，0.47-0.86；结直肠癌特异性生存期：HR，0.40；95%CI，0.20-0.80）。结直肠癌诊断后非甾体抗炎药物的使用与总生存期的相关性因KRAS突变情况而明显不同（交互性检验P=0.01），仅在KRAS野生型的肿瘤患者中结直肠癌诊断后使用非甾体抗炎药物与总生存期延长相关（HR，0.60；95%CI，0.46-0.80），而KRAS突变的肿瘤患者中则不相关（HR，1.24；95%CI，0.78-1.96）。
结论
在长期幸存者中，KRAS野生型的肿瘤患者结直肠癌诊断后常规使用甾体抗炎药物与生存期延长明显相关。
《壹篇》南南和北北
Timing of Aspirin and Other Nonsteroidal Anti-Inflammatory Drug Use Among Patients With Colorectal Cancer in Relation to Tumor Markers and Survival
Purpose
Regular use of aspirin is associated with improved survival for patients with colorectal cancer (CRC). However, the timing of and the subtype of CRC that would benefit the most from using aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) in relation to survival is unclear.
Patients and Methods
In all, 2,419 patients age 18 to 74 years with incident invasive CRC who were diagnosed from 1997 to were identified from population-based cancer registries in the United States, Canada, and Australia. Detailed epidemiologic questionnaires were administered at study enrollment and at 5-year follow-up. Survival outcomes were completed through linkage to national death registries. BRAF- and KRAS-mutation status, microsatellite instability, and CpG island methylator phenotype were also evaluated. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for overall survival (OS) and CRC-specific survival.
Results
After a median of 10.8 years of follow-up since diagnosis, 381 deaths (100 as a result of CRC) were observed. Compared with nonusers, postdiagnostic aspirin-only users had more favorable OS (HR, 0.75; 95% CI, 0.59 to 0.95) and CRC-specific survival (HR, 0.44; 95% CI, 0.25 to 0.71), especially among those who initiated aspirin use (OS: HR, 0.64; 95% CI, 0.47 to 0.86; CRC-specific survival: HR, 0.40; 95% CI, 0.20 to 0.80). The association between any NSAID use after diagnosis and OS differed significantly by KRAS-mutation status (Pinteraction = .01). Use of any NSAID after diagnosis was associated with improved OS only among participants with KRAS wild-type tumors (HR, 0.60; 95% CI, 0.46 to 0.80) but not among those with KRAS-mutant tumors (HR, 1.24; 95% CI, 0.78 to 1.96).
Conclusion
Among long-term CRC survivors, regular use of NSAIDs after CRC diagnosis was significantly associated with improved survival in individuals with KRAS wild-type tumors.
《壹篇》系主要面向医务人员的公益性头条号，不以营利为目的，不进行任何有偿咨询和服务，不出售任何产品，与ASCO、CSCO等所有专业学会和机构没有任何关系和联系，也不代表任何官方学会发声。
文章图片均来自网络，不做商业用途，若有版权争议请与《壹篇》联系。
坚持点赞、赞赏和转发是一种态度和支持。
如果觉得《临床肿瘤杂志发布研究果：只有特定类型直肠癌患者使用阿司匹林才有效》对你有帮助，请点赞、收藏，并留下你的观点哦！
