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Low-Dose Aspirin in High-Risk Individuals With Screen-Detected Subsolid Lung Nodules: A Randomized Phase II Trial.

  • Author(s): Bonanni, Bernardo;
  • Serrano, Davide;
  • Maisonneuve, Patrick;
  • Veronesi, Giulia;
  • Johansson, Harriet;
  • Aristarco, Valentina;
  • Varricchio, Clara;
  • Cazzaniga, Massimiliano;
  • Lazzeroni, Matteo;
  • Rampinelli, Cristiano;
  • Bellomi, Massimo;
  • Vecchi, Manuela;
  • Spaggiari, Lorenzo;
  • Vornik, Lana;
  • Brown, Powel H;
  • Beavers, Therese;
  • Guerrieri-Gonzaga, Aliana;
  • Szabo, Eva
  • et al.
Abstract

Lung cancer screening by helical low-dose computed tomography detects nonsolid nodules that may be lung adenocarcinoma precursors. Aspirin's anti-inflammatory properties make it an attractive target for prevention of multiple cancers, including lung cancer. Therefore, we conducted a phase IIb trial (NCT02169271) to study the efficacy of low-dose aspirin to reduce the size of subsolid lung nodules (SSNs). A total of 98 current or former smokers (67.3% current) undergoing annual low-dose computed tomography screening with persistent SSNs were randomly assigned to receive aspirin 100 mg/day or placebo for 1 year. There was no difference in change in the sum of the longest diameters of target nodules in the placebo and aspirin arm after 12 months of treatment (-0.12 mm [SD = 1.55 mm] and +0.30 mm [SD= 2.54 mm], respectively; 2-sided P = .33 primary endpoint). There were no changes observed in subgroup analyses by individual characteristics or nodule type. One year of low-dose aspirin did not show any effect on lung SSNs. SSNs regression may not be the proper target for aspirin, and/or longer duration may be needed to see SSNs modifications.

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