Anticoagulants Associated with Lower Mortality from High-Risk Prostate Cancer

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(ChemotherapyAdvisor) – Anticoagulant therapy – and aspirin in particular -- is associated with significantly lower mortality among prostate cancer patients who are treated with surgery or radiation, according to a study published in the Journal of Clinical Oncology.

“The results of this study suggest that aspirin prevents the growth of tumor cells in prostate cancer, especially in high-risk prostate cancer, for which we do not have a very good treatment currently,” reports lead author Kevin S. Choe, MD, PhD, assistant professor of radiation oncology at UT Southwestern Medical Center, Dallas, Texas.

At a median follow-up of 70 months, the 10-year prostate cancer-specific mortality (PCSM) rate was significantly lower among men taking the anticoagulants aspirin, warfarin, clopidogrel and/or enoxaparin (3% vs. 8%; P<0.01), the authors reported. Multivariate analysis and competing risk regression analysis confirmed aspirin as an independent correlate of lower PCSM (HR=0.43; 95% CI, 0.21 – 0.87; P<0.01).

Results “suggested that aspirin may offer more benefits than other anticoagulant medications,” Dr. Choe and his coauthors noted.

The study involved 5,955 participants in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) study who had high-risk localized prostate adenocarcinoma, and had received radical prostatectomy or radiotherapy.

Disease recurrence rates at 10 years were significantly lower among anticoagulant-arm participants than control-arm participants (28% vs. 36%, P<0.01). Bone metastasis risk was also significantly lower among men taking anticoagulants (10-year risk 3% vs. 6%, P<0.01). Subgroup analysis revealed that the association is not statistically significant among low-risk patients (P=0.12) and is most pronounced among men with high-risk prostate cancer (10-year PCSM 4% vs. 19%; log-rank P<0.01), the authors noted.  

The study follows a recent meta-analysis of data from 24 studies that also concluded aspirin is a probable chemopreventive agent for prostate tumor progression and metastasis, the authors noted.

“Our findings corroborate and strengthen the hypothesis that aspirin may have chemopreventive and antineoplastic effects,” Dr. Choe and colleagues concluded.


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