ASCOLT trial finds no major aspirin benefit for recurrence

A large international clinical trial called ASCOLT has finished investigating the use of aspirin to prevent the recurrence of colorectal cancer after standard treatments. This study, led by clinicians in Singapore, is the first of its kind to evaluate how effective and safe aspirin might be for patients who have completed surgery and chemotherapy for colorectal cancer. The results show that aspirin does not significantly improve disease-free survival for all patients. However, there is a trend suggesting it could help improve survival rates over time. In January 2025, another study called ALASCCA reported positive findings for colorectal cancer patients with a specific genetic mutation. This study found that taking aspirin for up to three years could reduce the risk of cancer recurrence by more than 50% in this particular group. The ASCOLT trial involved nearly 1,600 patients across 66 hospitals in 11 countries. Participants were randomly assigned to receive either 200 mg of aspirin daily or a placebo for three years. Despite facing challenges, including logistical issues and the COVID-19 pandemic, the trial was completed successfully. Although ASCOLT did not meet its main goal, it showed that aspirin was well tolerated and had a good safety profile, similar to that of the placebo. Researchers think aspirin could be beneficial for specific groups of colorectal cancer patients, especially those with certain genetic markers. With the promising results from both ASCOLT and ALASCCA, experts believe that aspirin could become an important part of treatment for early-stage colorectal cancer. This could significantly improve outcomes for patients globally, particularly for those in countries with limited healthcare resources. Researchers are now focusing on further analyzing data from ASCOLT to identify which patients might benefit the most from aspirin. They emphasize the need for more large-scale trials to explore the potential benefits of affordable treatments like aspirin in cancer care.