Aspirin Associated With Reduced Mortality in Patients With CRC Source: 2015 American Society of Clinical Oncology Annual Meeting* The largest cohort ever to examine the effects of aspirin as secondary prevention reveals that aspirin independently reduces the risk of both CRC-specific mortality and all-cause mortality. Format: Microsoft PowerPoint (.ppt) File size: 378 KB

1. May 29 - June 2, 2015
Aspirin Associated With Reduced
Mortality in Patients With CRC
CCO Independent Conference Highlights
of the 2015 ASCO Annual Meeting*
*CCO is an independent medical education company that
provides state-of-the-art medical information to healthcare
professionals through conference coverage and other
educational programs.
This program is supported by educational grants from AstraZeneca,
Bayer, Celgene Corporation, Genentech, Incyte, and Novartis.

2. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
Background
 Regular aspirin use associated with reduced CRC
incidence and mortality[1,2]
– Utility as primary prevention in general population debatable
given risk of serious hemorrhagic adverse effects
– Utility as secondary prevention may be more justified from
risk–benefit prospective and considering that aspirin
reverses tumor immune evasion in established CRC
 Current observational study represents largest cohort ever
examined evaluating effects of aspirin as secondary
prevention[3]
1. Lii P, et al. Gut. 2014;[Epub ahead of print]. 2. Flossmann E, et al. Lancet. 2007;369:1603-1613.
3. Bains S, et al. ASCO 2015. Abstract 3504.

3. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
Study Design
 Observational population-based cohort study in Norway
– Cancer Registry of Norway and Norwegian Prescription
Database used to retrospectively link pts diagnosed with
CRC from 2004-2011 and their use of aspirin
– Aspirin use defined as aspirin prescription for > 6 mos following
CRC diagnosis
– Registries cover > 99% of Norwegian population and provide
high-quality, validated data
 Primary endpoints: OS, cancer-specific survival
Bains S, et al. ASCO 2015. Abstract 3504.

4. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
Baseline Characteristics
Baseline Characteristic
Aspirin Use
P ValueNo
(n = 19,535)
Yes
(n = 6109)
Mean age, yrs 70.0 74.0 NR
Male, % 48.8 56.4 < .001
Tumor differentiation, %
Well
Moderate
Poor
Undifferentiated
6.0
60.9
18.2
0.2
7.2
65.9
14.3
0.2
< .001
Site of disease, %
Right
Transverse
Left
Rectum
30.9
6.9
26.3
34.2
32.7
6.6
26.4
32.9
.042
Bains S, et al. ASCO 2015. Abstract 3504.

5. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
Baseline Characteristics continued
Baseline Characteristic, %
Aspirin Use
P ValueNo
(n = 19,535)
Yes
(n = 6109)
AJCC disease stage
I
II
III
IV
20.3
27.1
26.6
23.6
26.0
34.5
26.2
9.4
< .001
Survival status
Alive
Dead due to CRC
Dead due to other reasons
Dead due to reasons unknown
61.1
32.5
5.2
1.1
65.8
19.2
10.9
4.1
< .001
Underwent primary surgery 88.1 95.8 .08
Bains S, et al. ASCO 2015. Abstract 3504.

6. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
OS and CSS
Survival
Outcome
Univariate Analysis Multivariate Analysis
HR (95% CI) P Value HR (95% CI) P Value
OS 1.03 (0.98-1.08) .25 0.86 (0.81-0.91) < .001
CSS 0.84 (0.79-0.90) < .001 0.75 (0.70-0.81) < .001

7. clinicaloptions.com/oncology
Aspirin Associated With Reduced Mortality in Patients With CRC
Aspirin as Secondary Prevention in CRC:
Conclusions
 In a cohort of more than 25,000 Norwegian individuals,
aspirin use after CRC diagnosis independently associated
with improved clinical outcomes
– Risk of CRC-specific mortality reduced by 25%
– Risk of all-cause mortality reduced by 14%
Bains S, et al. ASCO 2015. Abstract 3504.

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