Overview

• Randomized ALASCCA trial assigned patients with PI3K-pathway tumor alterations to 160 mg aspirin daily or placebo for three years after surgery.
• Among mutation-positive patients, aspirin cut recurrence risk by 55% versus placebo, according to results published in The New England Journal of Medicine.
• Investigators screened more than 3,500 patients across 33 hospitals in Sweden, Norway, Denmark, and Finland, and the target alteration appears in roughly 40% of tumors.
• Researchers cite plausible mechanisms involving anti-inflammatory, antiplatelet, and anti-tumor effects, though the precise pathways remain unresolved.
• Clinicians caution that benefits must be balanced against bleeding risks and note that results from broader, unselected groups have been mixed, underscoring the need for PI3K testing and careful patient selection.