M V Chandrakanth: Aspirin in CRC – Old Drug, New Precision Oncology?
M V Chandrakanth, Academic Head and Medical Oncologist at Narayana Health, shared a post on LinkedIn:
“Aspirin in CRC – Old Drug, New Precision Oncology?
ALASCCA | 4-part quick revision
Part 1 – Why Aspirin?
The biology: PI3K–COX/PGE2 signaling and platelet-mediated metastatic escape as proposed mechanisms.
Part 2 – Who Got Aspirin?
Resected localized CRC and PI3K-pathway alteration – aspirin 160 mg/day vs placebo × 3 years.
Part 3 – Did it Work?
Primary Group A: 3-year recurrence 14.1% – 7.7% | HR 0.49.
Benefit also seen in the broader PI3K-altered Group B; absolute benefit was greater in higher-risk disease.
Part 4 – What Does It Men?
A compelling example of biomarker-directed drug repurposing – but OS benefit is not yet proven, and subgroup signals require caution.
Take-home:
Not aspirin for every CRC – aspirin for the right biology.”

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