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Aspirin use has been shown to improve survival after treatment for colorectal cancer (CRC) and to reduce the risk for CRC in patients with Lynch syndrome. An important potential target for aspirin in CRC is cyclooxygenase-2 (COX-2). In a recent study, COX-2 overexpression in CRC tumors detected by immunohistochemistry correlated with survival improvement from aspirin use after treatment (JAMA 2009; 302:649). Also, mutation and upregulation of the PIK3CA kinase pathway might enhance COX-2 activity in colon cancer and interact with the effects of aspirin.
To examine the impact of PIK3CA kinase mutation on aspirin's potential to improve survival after CRC treatment, investigators studied 964 patients from the Nurses' Health Study and the Health…