A new study will investigate aspirin's potential as a treatment for an aggressive breast cancer.
In July 2021, scientists from Cardiff University argued the painkiller "appears to deserve serious consideration" as an add-on therapy for malignant cells.
Aspirin will now be tested alongside immunotherapy – drugs that help the immune system attack tumours – for triple negative breast cancer, an aggressive form of the disease that lacks three common molecules.
These patients typically have limited treatment options, with gruelling side effects.
In the first study of its kind – led by The Christie NHS Foundation Trust in Manchester – medics hope aspirin will improve immunotherapy's effectiveness, providing a treatment that is more easily tolerated than the go-to chemotherapy, surgery or radiotherapy regimens.
One triple negative breast cancer patient has described how she was "floored" by her conventional treatment.
As an immunotherapy add-on, aspirin – a "widely available and inexpensive" painkiller – could give patients newfound hope, she added.
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More than 55,000 new breast cancer cases arise every year in the UK, of which around 8,000 are triple negative, which disproportionately affects Black and young women.
These tumours lack oestrogen and progesterone receptors, as well as the so-called human epidermal growth factor receptor 2 (HER2), all of which are common treatment targets for other breast cancers.
Patients with the triple negative form of the disease usually rely on a combination of surgery, chemotherapy and radiotherapy – regimens that can cause nasty side effects.
Beth Bramall, from Hampshire, was diagnosed with triple negative breast cancer at 42 years old.
"Nothing prepares you for being diagnosed with cancer, but the narrative on triple negative breast cancer is so scary and provides little hope," she said.
"There's no easy cancer, but triple negative is particularly gruelling, with few treatment options and a long and debilitating treatment plan.
"It floored me with side effects of nerve damage, hair loss, nausea, joint and muscle pain, diarrhoea and constipation, burning palms and feet, migraines, night sweats and fatigue like I've never known before.
"I'm blessed I've had a pathological complete response to treatment, but it's been the hardest 18 months for me and my family, and I have over two more years of treatments and scans ahead."
Calling the study – funded by Breast Cancer Now – "really exciting", Bramall added it "could potentially help women diagnosed with triple negative breast cancer".
The immune system may be capable of destroying cancerous cells, however, the latter often evade identification. Immunotherapy therefore works to make the cells easier to spot and destroy.
Some forms of immunotherapy are already used for triple negative breast cancer, with mixed results.
Mice studies have suggested combining aspirin with the immunotherapy drug avelumab controls tumour growth more successfully than immunotherapy alone.
"Our earlier research has suggested aspirin can make certain types of immunotherapy more effective by preventing the cancer from making substances that weaken the immune response," said Dr Anne Armstrong, who will lead the study.
"Anti-inflammatory drugs like aspirin could hold the key to increasing the effectiveness of immunotherapy when used at the same time."
In the Christie Trust trial, patients will be given avelumab – with or without aspirin – before undergoing surgery and chemotherapy. Patients are being recruited, with the study set to last three years.
If successful, aspirin and avelumab will be tested on triple negative breast cancer patients whose cancer has spread and is considered to be incurable.
"Trialling the use of a drug like aspirin is exciting because it is so widely available and inexpensive to produce," added Dr Armstrong.
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