- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Low-Dose Aspirin Cuts Recurrence Risk in PI3K-Altered Colorectal Cancer, Trial Shows

Sweden: A new randomized trial has found that daily low-dose aspirin significantly lowers the risk of colorectal cancer recurrence in patients whose tumors harbor specific PI3K pathway alterations.
Published in the New England Journal of Medicine, the study led by Dr. Anna Martling of Karolinska Institutet demonstrates that aspirin not only reduces recurrence among patients with PIK3CA hotspot mutations but also provides similar benefits for those with other high- or moderate-impact variants in PI3K pathway genes.
The double-blind, placebo-controlled trial enrolled patients with stage I–III rectal cancer or stage II–III colon cancer who had somatic alterations in PI3K pathway genes, including PIK3CA, PIK3R1, and PTEN. Eligible participants were randomly assigned in a 1:1 ratio to receive either 160 mg of aspirin or a matched placebo once daily for three years. The primary focus was disease recurrence in patients with PIK3CA hotspot mutations in exon 9 or 20, referred to as group A alterations, while secondary outcomes included recurrence in patients with other PI3K-related mutations (group B), overall disease-free survival, and safety.
Out of 2,980 patients with complete genomic profiling, 1,103 (37%) had detectable PI3K pathway alterations. Among these, 515 had group A mutations and 588 had group B alterations.
The study led to the following findings:
- In the aspirin arm, the 3-year cumulative incidence of colorectal cancer recurrence for group A patients was 7.7%, compared with 14.1% in the placebo group, with a hazard ratio of 0.49.
- For group B patients, aspirin reduced recurrence to 7.7% versus 16.8% with placebo, corresponding to a hazard ratio of 0.42.
- Disease-free survival favored aspirin, with group A patients showing 88.5% survival versus 81.4% with placebo (hazard ratio, 0.61).
- Group B patients experienced 89.1% disease-free survival with aspirin compared to 78.7% with placebo (hazard ratio, 0.51).
- These results indicate that aspirin’s protective effect extends beyond PIK3CA hotspot mutations to other somatic alterations in the PI3K pathway.
- Severe adverse events occurred in 16.8% of aspirin recipients and 11.6% of placebo recipients.
- Most adverse events were consistent with known aspirin-related risks, primarily gastrointestinal complications.
- No unexpected safety issues were reported during the three-year treatment period.
The study provides strong evidence supporting the use of low-dose aspirin as an adjuvant therapy for patients with PI3K-altered colorectal cancer. By targeting tumors with specific molecular profiles, aspirin may serve as a precision therapy to reduce recurrence risk and improve long-term outcomes. While further studies may be needed to optimize dosing and patient selection, these findings highlight aspirin’s potential as a cost-effective and widely accessible intervention in molecularly defined colorectal cancer populations.
"The trial represents a major step toward integrating routine molecular profiling with targeted preventive strategies, offering new hope for patients with PI3K pathway–altered colorectal tumors," the authors concluded.
Reference:
Martling A, Hed Myrberg I, Nilbert M, Grönberg H, Granath F, Eklund M, Öresland T, Iversen LH, Haapamäki C, Janson M, Westberg K, Segelman J, Ersson U, Prytz M, Angenete E, Bergström R, Mayrhofer M, Glimelius B, Lindberg J; ALASCCA Study Group. Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer. N Engl J Med. 2025 Sep 18;393(11):1051-1064. doi: 10.1056/NEJMoa2504650. PMID: 40961426.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
Next Story