Biliary tract cancers have a dismal prognosis, with five-year survival rates ranging from 5% to 15%. In their publication in JAMA Oncology, Sarah S. Jackson, PhD, and colleagues report that aspirin increases survival in biliary tract cancers, including gallbladder cancer, cholangiocarcinoma, ampulla of Vater cancer, and overlapping lesions of the biliary tract. In this interview with i3 Health, Dr. Jackson discusses the potential ramifications of her study's findings.
What led you to pursue this investigation?
Sarah S. Jackson, PhD: Biliary tract cancers are a set of related but heterogeneous cancers that all have a poor prognosis. The median survival time is less than one year. Therefore, there is a critical need for therapies to extend these patients' lives. Aspirin has been investigated for its potential role in survival with other cancers because it reduces inflammation and may impede metastasis through inhibition of platelet aggregation. Increased inflammation is associated with prognosis in biliary tract cancer, so we wanted to examine whether we would see a benefit of taking aspirin in these patients.
Can you comment on the significance of your study's results?
Dr. Jackson: Our study found that taking aspirin after diagnosis improved survival at every cancer site, suggesting that controlling inflammation and slowing metastasis may help to extend life.
Given this evidence, should oncologists advise patients with biliary tract cancer to take aspirin except in situations where it is contraindicated?
Dr. Jackson: This is one observational study that offers promising results, but more studies are needed to replicate these results in other patient populations. Ideally, we would want to see evidence of survival benefit with aspirin in a randomized clinical trial before we begin to make recommendations.
Does any additional research need to be done on this topic? Do you have any further investigations under way?
Dr. Jackson: Definitely! Replication of these results in other patient populations is a key next step. We are particularly interested in replicating our findings in populations at high risk of biliary tract cancer, like those in Chile and Northern India, and are discussing possible follow-up studies with several colleagues.
About Dr. Jackson
Sarah S. Jackson, PhD, an epidemiologist, is a postdoctoral fellow in the Infectious and Immunoepidemiology Branch of the National Cancer Institute's Division of Cancer Epidemiology & Genetics. In addition to her research on risk factors for biliary tract cancer, she is studying the role of IFNL4 genotype in several infections. Her research interests also include epidemiologic methods and predictive modeling.
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Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of i3 Health.