Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy

Corbin D. Jacobs, Stephen G. Chun, Jingsheng Yan, Xian-Jin Xie, David A. Pistenmaa, Raquibul Hannan, Yair Lotan, Claus Roehrborn, Kevin S. Choe, D. W Nathan Kim

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: High-risk prostate cancer (PC) has poor outcomes due to therapeutic resistance to conventional treatments, which include prostatectomy, radiation, and hormone therapy. Previous studies suggest that anticoagulant (AC) use may improve treatment outcomes in PC patients. We hypothesized that AC therapy confers a freedom from biochemical failure (FFBF) and overall survival (OS) benefit when administered with radiotherapy in patients with high-risk PC. Materials and Methods: Analysis was performed on 74 high-risk PC patients who were treated with radiotherapy from 2005 to 2008 at UT Southwestern. Of these patients, 43 were on AC including aspirin (95.6%), clopidogrel (17.8%), warfarin (20%), and multiple ACs (31.1%). Associations between AC use and FFBF, OS, distant metastasis, and toxicity were analyzed. Results: Median follow-up was 56.6 mo for all patients. For patients taking any AC compared with no AC, there was improved FFBF at 5 years of 80% vs. 62% (P = 0.003), and for aspirin the FFBF was 84% vs. 65% (P = 0.008). Aspirin use was also associated with reduced rates of distant metastases at 5 years (12.2% vs. 26.7%, P = 0.039). On subset analysis of patients with Gleason score (GS) 9-10 histology, aspirin resulted in improved 5-year OS (88% vs. 37%, P = 0.032), which remained significant on multivariable analysis (P < 0.05). Conclusions: AC use was associated with a FFBF benefit in high-risk PC which translated into an OS benefit in the highest risk PC patients with GS 9-10, who are most likely to experience mortality from PC. This hypothesis-generating result suggests AC use may represent an opportunity to augment current therapy.

Original languageEnglish (US)
Pages (from-to)699-706
Number of pages8
JournalCancer Biology and Therapy
Volume15
Issue number6
DOIs
StatePublished - 2014

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Anticoagulants
Aspirin
Prostatic Neoplasms
Radiotherapy
Survival
Neoplasm Grading
clopidogrel
Neoplasm Metastasis
Warfarin
Therapeutics
Prostatectomy
Histology
Hormones
Mortality

Keywords

  • Anticoagulant
  • Aspirin
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Molecular Medicine
  • Pharmacology
  • Medicine(all)

Cite this

Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy. / Jacobs, Corbin D.; Chun, Stephen G.; Yan, Jingsheng; Xie, Xian-Jin; Pistenmaa, David A.; Hannan, Raquibul; Lotan, Yair; Roehrborn, Claus; Choe, Kevin S.; Kim, D. W Nathan.

In: Cancer Biology and Therapy, Vol. 15, No. 6, 2014, p. 699-706.

Research output: Contribution to journalArticle

Jacobs, Corbin D. ; Chun, Stephen G. ; Yan, Jingsheng ; Xie, Xian-Jin ; Pistenmaa, David A. ; Hannan, Raquibul ; Lotan, Yair ; Roehrborn, Claus ; Choe, Kevin S. ; Kim, D. W Nathan. / Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy. In: Cancer Biology and Therapy. 2014 ; Vol. 15, No. 6. pp. 699-706.
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abstract = "Purpose: High-risk prostate cancer (PC) has poor outcomes due to therapeutic resistance to conventional treatments, which include prostatectomy, radiation, and hormone therapy. Previous studies suggest that anticoagulant (AC) use may improve treatment outcomes in PC patients. We hypothesized that AC therapy confers a freedom from biochemical failure (FFBF) and overall survival (OS) benefit when administered with radiotherapy in patients with high-risk PC. Materials and Methods: Analysis was performed on 74 high-risk PC patients who were treated with radiotherapy from 2005 to 2008 at UT Southwestern. Of these patients, 43 were on AC including aspirin (95.6{\%}), clopidogrel (17.8{\%}), warfarin (20{\%}), and multiple ACs (31.1{\%}). Associations between AC use and FFBF, OS, distant metastasis, and toxicity were analyzed. Results: Median follow-up was 56.6 mo for all patients. For patients taking any AC compared with no AC, there was improved FFBF at 5 years of 80{\%} vs. 62{\%} (P = 0.003), and for aspirin the FFBF was 84{\%} vs. 65{\%} (P = 0.008). Aspirin use was also associated with reduced rates of distant metastases at 5 years (12.2{\%} vs. 26.7{\%}, P = 0.039). On subset analysis of patients with Gleason score (GS) 9-10 histology, aspirin resulted in improved 5-year OS (88{\%} vs. 37{\%}, P = 0.032), which remained significant on multivariable analysis (P < 0.05). Conclusions: AC use was associated with a FFBF benefit in high-risk PC which translated into an OS benefit in the highest risk PC patients with GS 9-10, who are most likely to experience mortality from PC. This hypothesis-generating result suggests AC use may represent an opportunity to augment current therapy.",
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T1 - Aspirin improves outcome in high risk prostate cancer patients treated with radiation therapy

AU - Jacobs, Corbin D.

AU - Chun, Stephen G.

AU - Yan, Jingsheng

AU - Xie, Xian-Jin

AU - Pistenmaa, David A.

AU - Hannan, Raquibul

AU - Lotan, Yair

AU - Roehrborn, Claus

AU - Choe, Kevin S.

AU - Kim, D. W Nathan

PY - 2014

Y1 - 2014

N2 - Purpose: High-risk prostate cancer (PC) has poor outcomes due to therapeutic resistance to conventional treatments, which include prostatectomy, radiation, and hormone therapy. Previous studies suggest that anticoagulant (AC) use may improve treatment outcomes in PC patients. We hypothesized that AC therapy confers a freedom from biochemical failure (FFBF) and overall survival (OS) benefit when administered with radiotherapy in patients with high-risk PC. Materials and Methods: Analysis was performed on 74 high-risk PC patients who were treated with radiotherapy from 2005 to 2008 at UT Southwestern. Of these patients, 43 were on AC including aspirin (95.6%), clopidogrel (17.8%), warfarin (20%), and multiple ACs (31.1%). Associations between AC use and FFBF, OS, distant metastasis, and toxicity were analyzed. Results: Median follow-up was 56.6 mo for all patients. For patients taking any AC compared with no AC, there was improved FFBF at 5 years of 80% vs. 62% (P = 0.003), and for aspirin the FFBF was 84% vs. 65% (P = 0.008). Aspirin use was also associated with reduced rates of distant metastases at 5 years (12.2% vs. 26.7%, P = 0.039). On subset analysis of patients with Gleason score (GS) 9-10 histology, aspirin resulted in improved 5-year OS (88% vs. 37%, P = 0.032), which remained significant on multivariable analysis (P < 0.05). Conclusions: AC use was associated with a FFBF benefit in high-risk PC which translated into an OS benefit in the highest risk PC patients with GS 9-10, who are most likely to experience mortality from PC. This hypothesis-generating result suggests AC use may represent an opportunity to augment current therapy.

AB - Purpose: High-risk prostate cancer (PC) has poor outcomes due to therapeutic resistance to conventional treatments, which include prostatectomy, radiation, and hormone therapy. Previous studies suggest that anticoagulant (AC) use may improve treatment outcomes in PC patients. We hypothesized that AC therapy confers a freedom from biochemical failure (FFBF) and overall survival (OS) benefit when administered with radiotherapy in patients with high-risk PC. Materials and Methods: Analysis was performed on 74 high-risk PC patients who were treated with radiotherapy from 2005 to 2008 at UT Southwestern. Of these patients, 43 were on AC including aspirin (95.6%), clopidogrel (17.8%), warfarin (20%), and multiple ACs (31.1%). Associations between AC use and FFBF, OS, distant metastasis, and toxicity were analyzed. Results: Median follow-up was 56.6 mo for all patients. For patients taking any AC compared with no AC, there was improved FFBF at 5 years of 80% vs. 62% (P = 0.003), and for aspirin the FFBF was 84% vs. 65% (P = 0.008). Aspirin use was also associated with reduced rates of distant metastases at 5 years (12.2% vs. 26.7%, P = 0.039). On subset analysis of patients with Gleason score (GS) 9-10 histology, aspirin resulted in improved 5-year OS (88% vs. 37%, P = 0.032), which remained significant on multivariable analysis (P < 0.05). Conclusions: AC use was associated with a FFBF benefit in high-risk PC which translated into an OS benefit in the highest risk PC patients with GS 9-10, who are most likely to experience mortality from PC. This hypothesis-generating result suggests AC use may represent an opportunity to augment current therapy.

KW - Anticoagulant

KW - Aspirin

KW - Prostate cancer

KW - Radiotherapy

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