Finding a "cure" for cancer is the Holy Grail of medical research. However, a single catch-all solution is unlikely; cancer comes in many shapes and forms.
Each type of cancer involves different cell types and cellular environments, mutations in a range of genes, and alterations to the way specific cells function; this makes understanding and treating cancer a complex battle.
Some researchers have referred to cancer as a "constellation" of diseases.
One particular type of cancer, which has mutations in a set of genes called RAS, is a particularly challenging type to treat.
Cancers with RAS mutations include some pancreatic, colorectal, and lung cancers, and a small number of melanomas; they have low survival rates. Currently, there are no pharmaceuticals specifically designed to target RAS mutant cancers.
One drug — Sorafenib — showed "marginal" benefits in a multicentre Phase III trial for one type of lung cancer. However, side effects were significant, causing some patients to drop out of the trial early.
Aspirin and cancer
Aspirin, or acetylsalicylic acid, has been used in one form or another since ancient times. For instance, Hippocrates referred to the use of salicylic tea to reduce fevers around 400 B.C. Aspirin is still used to treat a range of medical complaints.
Today, it is available over the counter and used to relieve pain and reduce fever. It is also prescribed to individuals who have had heart attacks and strokes as it significantly reduces the risk of another cardiovascular event.
With this relationship in mind, scientists from the University of Queensland in Australia recently set out to investigate whether adding aspirin to Sorafenib could increase its potency in cancers with RAS mutations.
The research team, led by Associate Professor Helmut Schaider, published their results this week in the journal Clinical Cancer Research. Using a mouse model, the results were encouraging.
"We found the addition of aspirin to a cancer inhibitor drug, Sorafenib, strongly enhanced its effectiveness against mouse models of lung cancer and melanoma with RAS mutations."
Dr. Helmut Schaider
Drilling down into the details, the scientists examined the molecular mechanisms that facilitated aspirin's positive effects. Dr. Schaider explains how the addition of a relatively high aspirin dose appears to improve outcomes:
"[T]wo molecular processes are activated and together they work to kill RAS mutant cancer cells. This dual activation also might prevent the tumors acquiring resistance to the treatment, which can happen when the inhibitor drug is given alone."
The future of Sorafenib and aspirin
The researchers believe that taking the drugs in combination may mean that patients could take Sorafenib in smaller doses, reducing the negative consequences of side effects.
The combination has the potential to extend the length of time cancer patients have without the disease progressing. Dr. Schaider says that "adding aspirin could also potentially prevent relapse of tumors in patients."
The next step is to investigate whether this positive interaction can be demonstrated in human patients; hopefully, follow-up work will not be too far down the line, as Dr. Schaider says:
"A clinical trial of the combination could proceed relatively quickly, potentially piggy-backing on other testing already underway."
Although, the adverse effects of taking high doses of aspirin would need to be managed; for instance, the chance of excessive bleeding is increased. For individuals with no other treatment options, however, the negative impacts of aspirin would be outweighed by the benefits.
Work is already underway to understand whether aspirin in conjunction with other cancer drugs might increase outcomes. If aspirin can impart a genuine benefit, it would be a significant and cost-effective step forward in cancer treatment.