Impact of aspirin on clinical outcomes for African American men with prostate cancer undergoing radiation.

Preclinical and clinical studies have suggested that aspirin (ASA) may exhibit antineoplastic activity. Particularly in prostate cancer, several reports have suggested that ASA plays a role in improved outcomes.

Therefore, we studied the role of ASA in a uniquely African American population, which is known to harbor more aggressive and biologically different disease compared to the general population.

We identified 289 African American men with prostate cancer who were treated with definitive radiation therapy to a dose of ≥7560 cGy. The median follow-up was 76 months. Kaplan-Meier analysis was used to analyze biochemical failure-free survival (bFFS), distant progression-free survival (DMPFS), and prostate cancer-specific survival (PCSS). Multivariate Cox regression was used to analyze the impact of covariates on all endpoints.

There were 147 men who were ASA+ and 142 who were ASA-. The 7-year bFFS was 80. 9% for ASA+ men and 70. 3% for ASA- men (p = 0. 03). On multivariate analysis, ASA use was associated with a significant reduction in biochemical recurrences (hazard ratio [HR] 0. 56, 95% confidence interval [CI] 0. 34-0. 93, p = 0. 03). The 7-year DMPFS was 98. 4% for ASA+ and 91. 8% for ASA- men (p = 0. 04). On multivariate analysis, ASA use was associated with a decreased risk of distant metastases (HR 0. 23, 95% CI 0. 06-0. 91, p = 0. 04). The 7-year PCSS was 99. 3% for ASA+ and 96. 9% for ASA- men (p = 0. 07).

In this study, ASA use was associated with improved biochemical outcomes and reduced distant metastases. This indicates that ASA appears to play an important antineoplastic role in African American men.

Tumori. 2015 Sep 30 [Epub ahead of print]

Virginia Wedell Osborn, Shan-Chin Chen, Joseph Weiner, David Schwartz, David Schreiber

SUNY Downstate Medical Center, Brooklyn, New York - USA.