Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer Res. 2021 Jul 15;81(14):3751-3761. doi: 10.1158/0008-5472.CAN-21-0758. Epub 2021 Apr 23.
Preclinical and clinical studies provide evidence for aspirin as a preventative agent for cancer. Compelling direct evidence supports a chemopreventive effect of aspirin in individuals at high risk of developing colorectal cancer due to Lynch syndrome, while indirect evidence indicates that aspirin may reduce the risk of and mortality from sporadic colorectal cancer. There is weaker evidence for a protective effect of aspirin against all cancers taken as a group. Nevertheless, the results of recent retrospective cohort studies consistently indicate a beneficial effect of aspirin as a chemopreventive or adjuvant chemotherapeutic agent in hepatocellular carcinoma (HCC). Epidemiologic studies conducted in the general population or in selected populations at higher risk for HCC reveal that regular aspirin use is associated with reduced HCC incidence. In addition, aspirin may act as an adjuvant to other therapies in reducing HCC recurrence. According to studies in animal models, the cancer-preventative effect of aspirin may be related to its antiplatelet and anti-inflammatory activities. Prospective studies are warranted to determine whether aspirin should be recommended to diverse populations of patients at risk for HCC.
临床前和临床研究为阿司匹林作为癌症预防剂提供了证据。强有力的直接证据支持阿司匹林在因林奇综合征而处于结直肠癌高风险的个体中具有化学预防作用，而间接证据表明阿司匹林可能降低散发性结直肠癌的风险和死亡率。阿司匹林对所有癌症的总体保护作用的证据较弱。然而，最近的回顾性队列研究结果一致表明，阿司匹林作为肝癌（HCC）的化学预防或辅助化疗药物具有有益作用。在普通人群或 HCC 风险较高的特定人群中进行的流行病学研究表明，定期使用阿司匹林可降低 HCC 的发病率。此外，阿司匹林可能在减少 HCC 复发方面作为其他治疗方法的辅助药物。根据动物模型研究，阿司匹林的癌症预防作用可能与其抗血小板和抗炎活性有关。有必要进行前瞻性研究，以确定是否应向有 HCC 风险的不同患者群体推荐阿司匹林。
