Impact of Aspirin on Clinical Outcomes for African American Men with Prostate Cancer Undergoing Radiation

• Published in: Tumori 2016-01, Vol.102 (1), p.65-70
• Main Authors: Osborn, Virginia Wedell, Chen, Shan-Chin, Weiner, Joseph, Schwartz, David, Schreiber, David
• Format: Article
• Language: English
• Subjects: African Americans - statistics & numerical data; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents, Hormonal - administration & dosage; Aspirin - administration & dosage; Biomarkers, Tumor - blood; Disease-Free Survival; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Medical Records; Middle Aged; Proportional Hazards Models; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - mortality; Prostatic Neoplasms - radiotherapy; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated; Retrospective Studies; Treatment Outcome; United States - epidemiology
• ISSN: 0300-8916; 2038-2529
• DOI: 10.5301/tj.5000424

Aims and background Preclinical and clinical studies have suggested that aspirin (ASA) may exhibit antineoplastic activity. Particularly in prostate cancer, several reports have suggested that ASA plays a role in improved outcomes. Therefore, we studied the role of ASA in a uniquely African American population, which is known to harbor more aggressive and biologically different disease compared to the general population. Methods We identified 289 African American men with prostate cancer who were treated with definitive radiation therapy to a dose of ≥7560 cGy. The median follow-up was 76 months. Kaplan-Meier analysis was used to analyze biochemical failure-free survival (bFFS), distant progression-free survival (DMPFS), and prostate cancer-specific survival (PCSS). Multivariate Cox regression was used to analyze the impact of covariates on all endpoints. Results There were 147 men who were ASA+ and 142 who were ASA-. The 7-year bFFS was 80.9% for ASA+ men and 70.3% for ASA− men (p = 0.03). On multivariate analysis, ASA use was associated with a significant reduction in biochemical recurrences (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.34-0.93, p = 0.03). The 7-year DMPFS was 98.4% for ASA+ and 91.8% for ASA− men (p = 0.04). On multivariate analysis, ASA use was associated with a decreased risk of distant metastases (HR 0.23, 95% CI 0.06-0.91, p = 0.04). The 7-year PCSS was 99.3% for ASA+ and 96.9% for ASA− men (p = 0.07). Conclusions In this study, ASA use was associated with improved biochemical outcomes and reduced distant metastases. This indicates that ASA appears to play an important antineoplastic role in African American men.