What do the Treaty of Versailles and breast cancer have in common? In 1919, following the defeat of Germany in World War I, Bayer was forced to give up the trademark for Aspirin as part of its country’s war reparations. In 2010 two physicians at Harvard Medical School – Michelle Holmes and Wendy Chen – published a paper in the Journal of Clinical Oncology where they showed that among women living at least one year after diagnosis of breast cancer, aspirin use was associated with a decreased risk of recurrence and death.
For the past four years Holmes and Chen have been trying to secure funding from the National Institutes of Health to conduct a randomized clinical trial (RCT) – the gold standard of research design – of aspirin use among women with breast cancer. Unfortunately the NIH has turned down their grant applications and so earlier this week they wrote an op-ed piece for The New York Times with the provocative title “A Cancer Treatment in Your Medicine Cabinet?”
Since the time of Hippocrates, willow bark – from which aspirin was originally derived – has been used as a painkiller. It’s not clear, though, why aspirin may be effective in treating breast cancer. We know that it reduces inflammation, and this could be important in counteracting tumour growth, but it might also play a role by inhibiting angiogenesis, the formation of new blood vessels that feed the tumour. Finally, it’s also possible that aspirin inhibits the production of oestrogen, a hormone that stimulates the growth of breast cancer cells.
The authors point out that Cancer Research UK, a British charity, is funding an RCT to examine the effects of aspirin on four cancers but the study will not be complete until 2025. They call upon the USA to maintain its role as the global leader in biomedical research by funding its own trial of aspirin in breast cancer. Holmes and Chen bemoan the fact that their federal government is willing to test new cancer drugs pushed by pharmaceutical companies, “seduced by the more novel treatments – the scientific equivalent of the latest smartphone” while generic drugs like aspirin “just aren’t sexy.”
The Harvard researchers are seeking $10 million to fund a five-year trial of 3,000 women with Stage II and III breast cancer: “If aspirin truly works, we estimate that we could save 10,000 lives per year in the United States, and 75,000 in the developing world.” Politics aside, that would be impressive.