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Observational Study
. 2014 Nov 27;107(1):345.
doi: 10.1093/jnci/dju345. Print 2015 Jan.

Aspirin and COX-2 inhibitor use in patients with stage III colon cancer

Kimmie Ng  1 , Jeffrey A Meyerhardt  2 , Andrew T Chan  2 , Kaori Sato  2 , Jennifer A Chan  2 , Donna Niedzwiecki  2 , Leonard B Saltz  2 , Robert J Mayer  2 , Al B Benson 3rd  2 , Paul L Schaefer  2 , Renaud Whittom  2 , Alexander Hantel  2 , Richard M Goldberg  2 , Alan P Venook  2 , Shuji Ogino  2 , Edward L Giovannucci  2 , Charles S Fuchs  2
Affiliations
Observational Study

Aspirin and COX-2 inhibitor use in patients with stage III colon cancer

Kimmie Ng et al. J Natl Cancer Inst. .

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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Figures

Figure 1.
Figure 1.
Recurrence-free, disease-free, and overall survival by aspirin or COX-2 inhibitor use. Survival curves were generated by the Kaplan-Meier method and two-sided P values calculated using the log-rank test. A) Recurrence-free survival according to consistent aspirin use. B) Disease-free survival (death events censored at five years) according to consistent aspirin use. C) Overall survival (death events censored at five years) according to consistent aspirin use. D) Recurrence-free survival according to COX-2 inhibitor use. E) Disease-free survival (death events censored at five years) according to COX-2 inhibitor use. F) Overall survival (death events censored at five years) according to COX-2 inhibitor use.
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Comment in

  • RE: Aspirin and COX-2 Inhibitor Use in Patients With Stage III Colon Cancer.
    Lee M, Gibbs P. Lee M, et al. J Natl Cancer Inst. 2015 Jun 4;107(8):djv149. doi: 10.1093/jnci/djv149. Print 2015 Aug. J Natl Cancer Inst. 2015. PMID: 26048994 Free PMC article. No abstract available.
  • Response.
    Ng K, Chan AT, Fuchs CS. Ng K, et al. J Natl Cancer Inst. 2015 Jun 4;107(8):djv150. doi: 10.1093/jnci/djv150. Print 2015 Aug. J Natl Cancer Inst. 2015. PMID: 26048995 Free PMC article. No abstract available.

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