Approximately 50% of individuals will receive a cancer diagnosis at some point in their lives, usually in their later years. Although cancer cells can separate and spread to other parts of the body, it is easiest to treat cancer that is contained in its original location. By strengthening the body’s immune response, aspirin may help prevent metastases, or secondary tumors, according to researchers looking into how cancer spreads. Aspirin assisted immune cells in eliminating cancer cells that were spreading in their mouse study. People are being studied to see if aspirin or medications that target the same pathway can help prevent or postpone the recurrence of cancers.

Based on data from 2010-2011, Cancer Research UK reports that half of all people in Wales and England who receive a cancer diagnosis will live for at least ten years following their diagnosis. For some of the more common cancers, the percentage is significantly higher. According to data from 2013 to 2017, over 75% of people in England who have been diagnosed with either prostate or breast cancer will still be alive ten years later. Early detection, before the cancer has a chance to spread from its original site, is essential to a successful outcome. Over 90% of cancer-related deaths occur after the disease has spread to another area of the body.

Researchers from the University of Cambridge in the United Kingdom have now found that aspirin, a widely accessible and inexpensive pain reliever, may be able to stop the spread of some cancers. Aspirin affected platelets, which are tiny cells that cause blood to clot, in mice by reducing their production of thromboxane A2 (TXA2), a clotting factor that inhibits immune T cells, according to a study published in Nature. These T cells can then eliminate any cancer cells that are spreading because TXA2 isn’t suppressing them as much.

The study generates a valid hypothesis on how to prevent cancer recurrence and spread using a very simple intervention for patients, according to Nilesh Vora, MD, a board-certified hematologist and medical oncologist who serves as the medical director of the MemorialCare Todd Cancer Institute at Long Beach Medical Center in Long Beach, CA. This article’s main point is that aspirin stops cancers from spreading by lowering TXA2 and releasing suppressed T cells. Although treatment for early-stage cancers has advanced significantly, if cancer cells have spread from the original tumor site, there is still a chance that the cancer will recur elsewhere in the body.

The immune system is weakened inside the original tumor’s microenvironment, making it less effective at eliminating cancer cells. However, the immune system may target these lone cancer cells once they migrate. There is a special window of opportunity for treatment when cancer first spreads because cancer cells are more susceptible to immune attack. Patients with early cancer who are at risk of recurrence should benefit greatly from therapies that target this window of vulnerability.

Surprising new use for old drug
In mice, the researchers had previously discovered 15 genes that affected the spread of cancer. They discovered that some primary cancers in the liver and lungs metastasized less frequently in mice deficient in a gene that produces the protein ARHGEF1. They deduced from this that ARHGEF1 inhibits T cells that eliminate metastatic cells. They then found that when cells are exposed to the clotting factor TXA2, this gene is activated. Although recent evidence now contradicts the data on heart attack and stroke prevention, aspirin is sometimes taken at low doses to lower the risk of blood clots, heart attacks, and strokes because it inhibits platelets’ production of TXA2.

Aspirin-treated mice experienced fewer metastases than control mice in the current study, which examined the mouse model of melanoma, an aggressive type of skin cancer. The aspirin allowed their T cells to kill cancer cells by releasing them from TXA2-induced suppression. According to a press release from Jie Yang, PhD, one of the study co-authors based at the University of Cambridge, It was a eureka moment when we found TXA2 was the molecular signal that activates this suppressive effect on T cells. Yang stated that before this, we were unaware of the significance of our findings in comprehending aspirin’s anti-metastatic action. It was a shocking discovery that led us in a completely different direction than we had originally intended.

Do the findings on aspirin and cancer also apply to people?
Yang emphasized the promise of the research team’s findings, pointing out that aspirin or other medications that might target this pathway might be more affordable than antibody-based treatments and, as a result, more widely available. However, the researchers caution that aspirin can have side effects and may not be suitable for everyone. Aspirin frequently causes indigestion, nausea, and irritation of the stomach or gut. Less frequent adverse effects include bruising, vomiting, stomach bleeding or inflammation, and worsening asthma symptoms. Rarely, it can result in hemorrhagic stroke, kidney failure, or brain bleeding, especially in people who take a daily dose.

The results were welcomed by Anton Bilchik, MD, PhD, a surgical oncologist who was not involved in this study. He is the Chief of Medicine and Director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in Santa Monica, CA. However, he informed MNT that these findings must first be confirmed in clinical trials involving human subjects. It is necessary to assess aspirin as an adjuvant to immunotherapy and chemotherapy in patients with more advanced cancers as well as aspirin alone in patients with earlier cancers who are not candidates for these treatments.

The good news is that human clinical trials have begun. To determine whether aspirin can prevent or postpone the recurrence of early-stage cancers, the researchers will work with Ruth Langley, MD, professor of oncology and clinical trials in the MRC Clinical Trials Unit at University College London, who is in charge of the Add-Aspirin clinical trial. According to Langley, who was not involved in the current study, people should only begin taking aspirin on a doctor’s recommendation. A small percentage of people may experience severe side effects from aspirin, such as stomach ulcers or bleeding. She underlined that it is crucial to know which cancer patients are most likely to benefit and to always consult your doctor before beginning aspirin.