Overview

• The ALASCCA randomized, double-blind, placebo-controlled trial screened more than 3,500 post-surgery patients at 33 hospitals in Sweden, Norway, Denmark and Finland.
• Genetic testing identified 1,103 patients (about 37%) with PI3K-pathway alterations who were assigned to 160 mg aspirin daily or placebo for three years.
• At three years, the estimated cumulative incidence of recurrence was 7.7% with aspirin versus 14.1% with placebo, reflecting a 55% relative reduction.
• Serious adverse events potentially linked to aspirin included gastrointestinal and intracranial bleeding and an allergic reaction; four deaths were reported overall, with one possibly aspirin-related.
• Authors note limited follow-up for overall survival, restricted power for detailed subgroups, and exclusion of patients older than 80, highlighting the need for careful clinical implementation.