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SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Prospective, double-blinded, placebocontrolled randomized trial of adjuvant aspirin treatment in PIK3CA mutated colon cancer patients Prof. Dr. med. Ulrich Güller, MD, MHS, FEBS PD Dr. med. et phil. Markus Jörger, MD, PhD SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Rationale • Aspirin inhibits cyclo-oxygenase-2 • Inhibition of cyclo-oxygenase-2 results in down-regulation phosphatidylinositol 3-kinase (PI3K) signaling activity Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Background • Retrospective analysis • Data from the Nurses` Health Study and the Health Professionals Follow-up Study • 964 patients with colorectal cancer • 17% PIK3 mutations • Data containing aspirin use (325mg/day) and PIK3CA mutation Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Cancer-Specific Survival Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Overall Survival Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Study Proposal: Inclusion Criteria • • • • • • • • Patients aged 18 – 85 years Histologically proven colon adenocarcinoma Complete (R0) Resection Stage II and III Life expectancy > 3 years Willing to consent No medical conditions requiring aspirin or NSAIDS No upper GI-bleeding within the past 12 months • PIK3CA mutation Güller/Horber SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Study Proposal Potentially eligible colon cancer patients PIK3CA testing PIK3CA mutated patients 2:1 Randomization Aspirin 300mg daily/ Standard Chemo if indicated Follow-up Placebo daily/ Standard Chemo if indicated Follow-up SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Critical Issues • Large number needed to screen (n= 1088) • Funding Strengths • • • • Relevant public health problem Feasibility: Simple intervention Novelty Enthusisam in Medical Oncology Community SAKK 41/13: PIK3CA-Mutations Aspirin Colon Cancer Acknowledgements • • • • • • • • • Dr. med. et sc. D. Horber Dr. phil. Ch. Pilop, Head Trial Coordinator SAKK Dr. phil. Stefanie Hayoz, SAKK Statistician Mr. Severin Strasky, Funding Specialist SAKK Prof. Dr. med. A. Roth Prof. Dr. W. Jochum Prof. B. Thürlimann, President SAKK Dr. med. M. Montemurro, President SAKK GI Group Prof. Th. Cerny Güller/Horber