The mortality reducing effect of aspirin in colorectal cancer patients: Interpreting the evidence

Frouws, Martine A.; Herk‐Sukel, Myrthe P. P. van; Maas, Huub; Velde, Cornelis J.H. van de; Portielje, Johanneke E.A.; Liefers, Gerrit‐Jan; Bastiaannet, E.

doi:10.1016/j.ctrv.2016.12.008

Cited by 35 publications

(30 citation statements)

References 67 publications

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“…In a commentary that details a number of possible sources of bias, Frouws and colleagues comment that ‘oncologists may withhold aspirin treatment in the most seriously ill patients because of the poor prognosis, leading to reverse causality’ [ 65 ]. We see no way to examine this particular bias, and yet, on the other hand, if physicians had withdrawn aspirin from patients who were seriously ill or showed marked deterioration this could have led to a rebound in vascular deaths [ 66 – 68 ], and the evidence presented for all-cause mortality makes it seem likely that if any such a process did occur, it must have been minor.…”

Section: Discussionmentioning

confidence: 99%

Systematic review update of observational studies further supports aspirin role in cancer treatment: Time to share evidence and decision-making with patients?

et al. 2018

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BackgroundEvidence is growing that low-dose aspirin used as an adjuvant treatment of cancer is associated with an increased survival and a reduction in metastatic spread. We therefore extended up to August 2017 an earlier systematic search and meta-analyses of published studies of low-dose aspirin taken by patients with a diagnosis of cancer.MethodsSearches were completed in Medline and Embase to August 2017 using a pre-defined search strategy to identify reports of relevant studies. References in all the selected papers were scanned. Two reviewers independently applied pre-determined eligibility criteria and extracted data on cause-specific cancer deaths, overall mortality and the occurrence of metastatic spread. Meta-analyses were then conducted for different cancers and heterogeneity and publication bias assessed. Sensitivity analyses and attempts to reduce heterogeneity were conducted.ResultsAnalyses of 29 studies reported since an earlier review up to April 2015 are presented in this report, and these are then pooled with the 42 studies in our earlier publication. Overall meta-analyses of the 71 studies are presented, based on a total of over 120 thousand patients taking aspirin. Ten of the studies also give evidence on the incidence of metastatic cancer spread.There are now twenty-nine observational studies describing colorectal cancer (CRC) and post-diagnostic aspirin. Pooling the estimates of reduction by aspirin which are reported as hazard ratios (HR), gives an overall HR for aspirin and CRC mortality 0.72 (95% CI 0.64–0.80). Fourteen observational studies have reported on aspirin and breast cancer mortality and pooling those that report the association with aspirin as a hazard ratio gives HR 0.69 (0.53–0.90). Sixteen studies report on aspirin and prostate cancer mortality and a pooled estimate yields an HR of 0.87 (95% CI 0.73–1.05). Data from 12 reports relating to other cancers are also listed. Ten studies give evidence of a reduction in metastatic spread; four give a pooled HR 0.31 (95% CI 0.18, 0.54) and five studies which reported odds ratio of metastatic spread give OR 0.79 (0.66 to 0.95).ConclusionBeing almost entirely from observational studies, the evidence of benefit from aspirin is limited. There is heterogeneity between studies and the results are subject to important biases, only some of which can be identified. Nevertheless, the evidence would seem to merit wide discussion regarding whether or not it is adequate to justify the recommendation of low-dose therapeutic aspirin, and if it is, for which cancers?

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Section: Discussionmentioning

confidence: 99%

Systematic review update of observational studies further supports aspirin role in cancer treatment: Time to share evidence and decision-making with patients?

et al. 2018

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“…The synergic effect of combining a non-steroidal anti-inflammatory drug (NSAID) with an immune checkpoint inhibitor is supported by preclinical data: aspirin induced upregulation of PD-L1 and PD-L2 expression [72] . In a trial by Zelenay et al [73] , the combination of COX-inhibitor and PD-1 inhibitor, was effective in eradicating BRAF-mutated melanoma neoplastic cells in mice with a significant increase in IFN, CXCL10, IL12 expression as immune-stimulating factors.…”

Section: Other Strategies To Enhance the Immunoterapy Effectmentioning

confidence: 80%

Immunotherapy in the treatment of colorectal cancer: a new kid on the block

Spallanzani¹,

Gelsomino²,

Caputo³

et al. 2018

JCMT

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In the last few years, the success of anti-PD1 and anti-PDL1 drugs in solid cancers treatment and the advances in molecular biology have provided new potential treatment strategies for patients with metastatic colorectal cancer. Unfortunately, only patients with mismatch repair deficiency seem to benefit from immunotherapy and they represent a small subset of the metastatic population. New ongoing studies focus on converting an immune ignorant tumour into an inflamed one by combination therapies and on introducing an immunotherapeutic approach in earlier stages of disease (neoadjuvant and adjuvant setting). In this review we summarize the current knowledge about the molecular and immune landscape of colorectal cancer and propose new potential combination strategies to enhance the efficacy of immunotherapy.

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“…Its synthesized compound was tested for antioxidant activity. Synthesized compound characterized by 1 H NMR, 13 C NMR, and Mass spectroscopy.…”

Section: Fig 19: One-pot Three Component Coupling Reaction Scheme Ofmentioning

confidence: 99%

“…Zacharski et al, demonstrated a beneficial effect of warfarin in cancer patients leading to prolonged survival 13 . These derivatives have also been shown to be lipid-lowering agents that possess moderate triglyceride-lowering activity 14 .…”

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2019

IJPSR

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Indole and coumarin are the most versatile and cogent heterocyclic scaffolds which are not only decisively used in the synthesis of various organic compounds but also play a consequence role in natural product synthesis, modulation of biofilm formation, virulence and stress responses. In last few decades, an individual has witnessed considerable activity towards the synthesis of indole derivatives due to the possibilities for the design of polycyclic structures by the incorporation of multiple fused heterocyclic scaffolds in an attempt to achieve promising new heterocycles with chemical and biomedical relevance. Whereas, coumarin is a 2-oxo-2H-1-benzopyran and, also, have a wide range of application in the pharmaceutical field. In this review, we provide an overview of the synthesis of coumarin and indoles and their pharmacological evolution. The coumarin was synthesized using phenols, salicylaldehyde, benzaldehyde, phenylacetate, styrenes, and cinnamic acid with different catalyst and photocatalyst to give the best yield. Similarly, Indoles were synthesized iodobenzoic acid, alkynes, amines, alcohols, Nitrobenzaldehyde with the different catalyst under conventional and irradiation method. The effect of various catalytic medium, solvents and operational condition are discussed for obtaining the best yield. A comparative account of various reaction pathways like one-pot synthesis (Multicomponent reaction) and the multistep reaction of coumarin and indoles are discussed. INTRODUCTION: Coumarins belong to a large family of heterocyclic compounds with a benzo-apyrone moiety, of natural and synthetic origin. Coumarin is the most representative molecule are widely distributed in plants like tonka bean (Dipteryx odorata Wild). It has been extensively used in biochemical and pharmaceutical fields 1 .

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The mortality reducing effect of aspirin in colorectal cancer patients: Interpreting the evidence

Cited by 35 publications

References 67 publications

Systematic review update of observational studies further supports aspirin role in cancer treatment: Time to share evidence and decision-making with patients?

Systematic review update of observational studies further supports aspirin role in cancer treatment: Time to share evidence and decision-making with patients?

Immunotherapy in the treatment of colorectal cancer: a new kid on the block

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