Aspirin helps some survive breast cancer but makes it worse in others

Aspirin may help some survive breast cancer – but it could make the disease more aggressive in others

  • Previous research has found aspirin could help cancer patients
  • But new research by University of North Carolina scientists suggests it depends on the genetic characteristics of the patient and tumor

Aspirin may be a Russian Roulette for people with breast cancer, according to new research.

It could boost patients’ odds of survival, as previous studies have found – likely by dampening inflammation.

However, that hasn’t always rung true for all breast cancer patients, calling the theory into question.  

Today, researchers at the University of North Carolina have suggested a reason: it may all boil down to the genetic characteristics of the tumor and the patient. 

Their evidence, published today in the journal CANCER, suggests the chemicals in aspirin may affect DNA methylation, a process that regulates which genes express themselves. 

In some, it may work well, hampering the tumor, and strengthening the body’s defenses – but in others, it may do quite the opposite. 

Aspirin has been said to help breast cancer patients boost their chances of survival, but that hasn’t always rung true for everyone, calling the theory into question (file image)

‘Chronic inflammation is a key player in the development of multiple cancer types, including breast cancer,’ first author Tengteng Wang, who led this study while she was a doctoral candidate in the epidemiology department at the Gillings School, said in a press release. 

‘Aspirin is a major non-steroidal anti-inflammatory drug which has anti-inflammatory properties. Given this, substantial evidence from laboratory and population studies suggests that taking aspirin may reduce the risk of developing breast cancer.’   

Dr Wang is hardly the first to look into this aspirin-cancer conundrum, but the first to look at how DNA methylation might be involved. 

It is a process we have known about for decades but it is only in the 21st century that scientists have started to draw more solid links between DNA methylation and disease – and how commonly prescribed medications could play a role. 

Dr Wang, along with her mentor Dr Marilie Gammon, landed on 13 breast cancer-related genes that they wanted to analyze in tumors and in patients’ cells.  

To investigate, they pulled data on 1,266 patients in the Long Island Breast Cancer Study, who were diagnosed in 1996 and 1997, and followed until 2014.

By the end of the research period, 476 had died – 202 of whom had specifically died from breast cancer.

The team found some patients who took aspirin did have a lower death risk – but only if their DNA was not methylated in the region that controlled the BRCA1 gene.

In those who did carry the BRCA1 gene – i.e. the gene Angelina Jolie carries, which led her to get a double mastectomy – it was not protective.  

Dr Marilie Gammon, who mentored corresponding author Dr Tengteng Wang, said the findings may help 

‘Our findings, if confirmed, may … impact clinical decision-making by identifying a subgroup of patients, using epigenetic markers, for whom pre-diagnosis aspirin use impacts subsequent mortality,’ Dr Gammon said.  

Future research should consider a more comprehensive DNA methylation profile in order to better characterize women who are at risk, said the researchers.

Dr Kristen Malecki, an epidemiologist at the University of Wisconsin-Madison who was not involved in the study, said the findings support the importance of research examining interactions between epigenetics and low-cost therapies such as aspirin.

‘The study by Wang et al. shows that beyond gene-environment interactions, epigenetic and environment interactions also exist, and suggest that DNA methylation could in the future help to support the identification of individuals for whom treatment may or may not be successful,’ Dr Malecki said.  

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