A new study published in JAMA Oncology shows that a simple blood test could help doctors decide which colon cancer patients may benefit from taking anti-inflammatory medicine along with chemotherapy after surgery.
The findings suggest that this personalized approach may improve survival and reduce the risk of cancer returning.
Colon cancer is one of the most common types of cancer in the United States, with around 110,000 new cases diagnosed each year. For patients with stage III colon cancer, even after surgery and chemotherapy, the cancer returns in up to 40% of cases.
Doctors have long suspected that certain anti-inflammatory medicines, like celecoxib, might help prevent the cancer from coming back.
Celecoxib is a prescription drug that belongs to a group called NSAIDs (nonsteroidal anti-inflammatory drugs), which also includes aspirin and ibuprofen. But previous clinical trials did not show a clear benefit for all patients, so it remained unclear who should take these medications.
This new study offers important clues. Researchers looked at something called circulating tumor DNA, or ctDNA. These are tiny pieces of cancer DNA that can still be found in the blood after surgery. If ctDNA is present, it may mean that some cancer cells remain in the body, increasing the risk of the cancer returning.
The study found that patients who tested positive for ctDNA after surgery were much more likely to have their cancer return. For these high-risk patients, adding celecoxib to their chemotherapy significantly improved survival rates.
Patients who did not have ctDNA in their blood did not benefit from the extra medication, meaning they could avoid taking unnecessary drugs.
Doctors can measure ctDNA by taking a regular blood sample and using gene testing to look for traces of cancer DNA.
Dr. George Q. Zhang, a surgery resident at Brigham and Women’s Hospital and lead author of the study, said this blood test could help doctors know who might benefit from anti-inflammatory treatment. “Until now, we didn’t know how to identify which patients would benefit,” Zhang said. “This test could change that.”
The clinical trial—called CALGB (Alliance) 80702—followed more than 2,500 patients with stage III colon cancer who had undergone surgery. For this specific analysis, researchers looked at blood samples from 940 of those patients. Among them, 173 tested positive for ctDNA and 767 tested negative.
For patients with ctDNA in their blood, those who took celecoxib had better outcomes. After three years, about 41% of the celecoxib group had no sign of cancer, compared to just 22.6% in the group that didn’t take the drug. After five years, survival was also better: 61.6% of patients who received celecoxib were still alive, compared to 39.9% of those who didn’t.
Dr. Jeffrey Meyerhardt from the Dana-Farber Cancer Institute, who helped lead the study, said the goal was to see if adding celecoxib to chemotherapy helped patients live longer. While the overall results of the trial didn’t confirm this for everyone, this deeper look at ctDNA showed a clear benefit for a certain group of patients.
Dr. Zhang noted that more research is needed before this becomes a standard part of care. Still, the results are promising and show how a simple blood test could make a big difference in tailoring treatments for colon cancer patients.
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