A new study suggests a simple blood test could help doctors determine which colon cancer patients may benefit from adding anti-inflammatory medication to chemotherapy after surgery. The findings, published in JAMA Oncology, could pave the way for more personalized treatments and improved outcomes.
Colon cancer is one of the most common cancers in the United States, with roughly 110,000 new cases diagnosed each year, according to the American Cancer Society. Despite surgery and chemotherapy, up to 40% of patients with stage III disease experience a recurrence.
Celecoxib, a prescription nonsteroidal anti-inflammatory drug (NSAID) similar to aspirin and ibuprofen, is often used to relieve arthritis pain. Researchers have long suspected that the anti-inflammatory properties of NSAIDs could help prevent colon cancer recurrence, as inflammation contributes to tumor growth. However, previous clinical trials showed inconsistent benefits, leaving doctors uncertain about which patients should take the drug.
The new analysis offers clarity. Researchers examined circulating tumor DNA (ctDNA)—tiny fragments of cancer DNA that can remain in the blood after surgery. Patients who tested positive for ctDNA were at higher risk of cancer recurrence. For these high-risk patients, adding celecoxib to chemotherapy significantly improved survival. Patients who tested negative for ctDNA did not benefit, allowing them to avoid unnecessary medication. Clinicians can measure ctDNA through a simple blood test using gene sequencing.
“The main goal of CALGB (Alliance) 80702 was to determine if adding celecoxib to chemotherapy after surgery for colon cancer improved survival,” said study chair Jeffrey Meyerhardt, MD, MPH, a medical oncologist at Dana-Farber Cancer Institute. “Although the initial trial didn’t confirm our hypothesis overall, we saw that some patients benefited. This study identifies those with detectable ctDNA after surgery as a group that gains the most from celecoxib.”
The trial, supported by the National Cancer Institute, enrolled over 2,500 patients with stage III colorectal cancer who had undergone tumor removal. This analysis focused on ctDNA samples from 940 patients—767 ctDNA negative and 173 ctDNA positive. Among ctDNA-positive patients, celecoxib nearly doubled disease-free survival over three years, from 22.6% with placebo to 41%. Five-year overall survival was 61.6% for those receiving celecoxib, compared with 39.9% in the placebo group.
“Although these results are encouraging, additional prospective research is needed to confirm them,” said Dr. Zhang, a study co-author.
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