Biliary tract cancer: aspirin use linked to reduced mortality

  • Jackson SS & al.
  • JAMA Oncol
  • 17 Oct 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Aspirin use was associated with reduced risk of death in biliary tract cancer (BTC), and new users seemed to benefit most.

Why this matters

  • Aspirin might slow metastasis by interfering with platelet activation.

Study design

  • Retrospective analysis of UK’s Clinical Practice Research Datalink database (n=2934).
  • Funding: NIH; National Cancer Institute.

Key results

  • 23% of patients had gallbladder cancer (GBC), 53% had cholangiocarcinoma, 8% had ampulla of Vater cancer (AVC), and 16% were overlapping.
  • 82% of patients died and the median survival was 5.8 (interquartile range, 2-15) months.
  • 9% were using aspirin at baseline, and 12% initiated aspirin after diagnosis. 96% were prescribed a 75 mg dose.
  • Aspirin users were more likely to be older, current statin users, and to use aspirin before their diagnosis. Heart disease and comorbidities were more common in aspirin users.
  • There was an association between aspirin use and decreased mortality risk in:
    • GBC: HR, 0.63; 95% CI, 0.48-0.83.
    • cholangiocarcinoma: HR, 0.71; 95% CI, 0.60-0.85.
    • AVC: HR, 0.44; 95% CI, 0.26-0.76.
    • overlapping BTC: HR, 0.68; 95% CI, 0.50-0.92.
  • In all categories, the survival benefit was higher in patients who had not used aspirin before diagnosis.

Limitations

  • Retrospective analysis.