The researchers found that there was no significant improvement in disease-free survival (DFS) with celecoxib for all patients. On stratification by PIK3CA status, patients with gain-of-function mutations treated with celecoxib had significantly improved DFS (adjusted hazard ratio, 0.56 [95 percent confidence interval, 0.33 to 0.96]) compared with wildtype PIK3CA patients (adjusted hazard ratio, 0.89 [0.70 to 1.14]); the interaction was not significant. Patients with PIK3CA gain-of-function mutations had similarly improved overall survival (adjusted hazard ratio, 0.44 [0.22 to 0.85]) compared with wildtype patients (adjusted hazard ratio, 0.94 [0.68 to 1.30]). "These findings represent the first clinical trial results to validate observational studies that have associated adjuvant aspirin and other nonsteroidal anti-inflammatory drug use, including COX-2 inhibitorsCOX-2 inhibitors, with improved survival for patients with PIK3CA-mutant colorectal cancer," the authors write. Several authors disclosed ties to the biopharmaceutical industry.
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