ASCO Expert Perspective
“These data find that aspirin is likely not a tool we can use to decrease the chance of cancer coming back among ER+ or triple-negative breast cancer patients. However, if people need to be on aspirin for other reasons, they absolutely should take it as it appears to neither help nor hurt breast cancer outcome.” – Erika P. Hamilton, MD, ASCO Expert in Breast Cancer

Taking aspirin daily did not improve invasive disease-free survival (iDFS) in breast cancer patients, according to research being presented in the February 15, 2022, ASCO Plenary Series session. 

Previous observational studies and cardiovascular disease trials have suggested regular aspirin users had improved breast cancer survival and decreased risk of metastatic cancer of any kind.1,2 This is the first randomized placebo-controlled trial to evaluate the efficacy of aspirin in preventing breast cancer recurrence among breast cancer survivors.

In this double-blind study, 3,021 patients with high-risk, HER2-negative breast cancer were randomly selected to receive either aspirin or a placebo daily for five years. After 191 iDFS events (107 in patients taking aspirin and 84 in patients taking placebo) and a median follow-up of 20 months, the study was closed early because the data showed it was unlikely that aspirin would be helpful in preventing breast cancer recurrence. There was no difference in the frequency of grade 3 and 4 adverse events between study arms.

The authors plan to conduct additional analyses on tumor and blood samples collected from participants at baseline and repeat blood samples that were collected at two years.

“Although inflammation may still play a role in cancer progression, aspirin is not recommended for prevention of breast cancer recurrence,” said lead author Wendy Y. Chen, MD, MPH, medical oncologist at the Dana Farber Cancer Institute.

Abstract and presentation will be available here on February 15, 2022, at 3:00 p.m. ET.

Funding information is noted in the abstract

View Dr. Hamilton's disclosures: https://coi.asco.org/share/2FF-N4HM/Erika%20Hamilton

View the authors' disclosures: https://coi.asco.org/Report/ViewAbstractCOI?id=360922

ATTRIBUTION TO THE ASCO PLENARY SERIES IS REQUESTED IN ALL COVERAGE.

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View the Abstract

1. Lancet 2011 Jan 1;377(9759):31-41. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials

2. Breast Cancer Res Treat 2015 Feb;150(1):199-207. Association between aspirin use and mortality in breast cancer patients: a meta-analysis of observational studies

About ASCO: 

Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to the principle that knowledge conquers cancer. Together with the Association for Clinical Oncology, ASCO represents nearly 45,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of high quality, equitable patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. Conquer Cancer, the ASCO Foundation, supports ASCO by funding groundbreaking research and education across cancer’s full continuum.