Kanazawa, S., Yamaguchi, K., Kinoshita, Y., Muramatsu, M., Komiyama, Y., & Nomura, S. (2006). Aspirin reduces adverse effects of gefitinib. Anti-Cancer Drugs, 17, 423–427.

To investigate the effects of low-dose aspirin on some adverse effects of gefitinib

Patients were recruited when admitted to the hospital for assessment of lung cancer. For the first two years, patients did not receive aspirin. In 2003, patients were started on aspirin 100 mg/day along with gefitinib treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids were continued in all patients.

• The study reported on 40 patients.  
• Median age was 67 years, with a range of 42–82 years.
• The sample was 60% male and 40% female.
• All patients had lung cancer, with approximately 60% having stage IV disease.
• Some patients who did not receive aspirin also were getting concurrent chemotherapy in addition to the EGFRI.

• Single site
• Inpatient setting
• Japan

Patients were undergoing active antitumor treatment.

The study was a retrospective analysis of treated versus untreated cases.

No instruments or methods were described for toxicity rating.

Overall frequency of EGFRI-related adverse events was 77.8% in those not treated with aspirin and 58.3% in those who received aspirin. Skin rash incidence was 33.3% in those on aspirin and 74.1% of those not on aspirin. There was no apparent difference in gefinitib response between groups.

Findings suggest that aspirin may help to reduce the incidence of some gefinitib toxicities, however, no clear conclusions can be made due to study limitations.

• The study had a small sample, with less than 100 participants.
• The study had baseline sample/group differences of import.
• The study had risk of bias due to lack of control group, blinding, and random assignment.
• Measurement/methods were not described.
• Definition of toxicities and skin rash were not stated, and no statistical analysis was done to determine any difference in incidence reported.
• Historical group not on aspirin was stated to also be receiving other chemotherapy, which could have affected toxicity development.
• Concomitant use of steroids and NSAIDs was stated but not described.

This study aimed to report the effects of low-dose aspirin for prevention of toxicities with gefinitib. The study does not provide strong support for this intervention; however, results suggest that further research in the use of low-dose aspirin could be beneficial.