Aspirin after curative-intent treatment of colorectal cancer liver metastases (ASAC): a multicentre, phase 3, randomised, double-blind, placebo-controlled trial.

Aspirin does not improve disease-free survival and reduces overall survival in patients after curative treatment of colorectal cancer liver metastases, with increased serious adverse events.

• Why it matters: Understanding whether aspirin can prevent recurrence after metastatic colorectal cancer treatment is crucial, as recurrence is common and current options are limited. Clarifying aspirin’s role could influence post-treatment care strategies.
• What they did: A multicentre, phase 3, randomized, double-blind, placebo-controlled trial involving 428 patients assessed the effect of daily 160 mg aspirin versus placebo over up to 3 years, measuring disease-free survival and adverse events.
• The result: Aspirin did not improve disease-free survival (median 1.13 vs 1.40 years) and was associated with lower overall survival (76% vs 85% at 36 months), along with more serious adverse events, indicating it should not be routinely used post-treatment.