The inaugural grant by Swiss-based Rising Tide Foundation for Clinical Cancer Research will support an international collaboration led by Singapore researchers at National Cancer Centre Singapore (NCCS). This provocative study, the first randomised trial to address the role of aspirin in post-operative colorectal cancer, could potentially change the current standard of care and bring immense benefit to a large group of patients worldwide as aspirin is inexpensive, reasonably safe and widely available
Rising Tide Foundation for Clinical Cancer Research (RTFCCR), an international private foundation based in Switzerland, has awarded a US $800,000 grant to be released over two years for the ASCOLT study conducted by Dr John Chia, Senior Consultant Medical Oncologist at the Division of Medical Oncology, National Cancer Centre Singapore (NCCS).
The grant support from RTFCCR fills an important void to cover the cost for this trans-Asian study as it will be used to pay for both study- and patient-related costs outside of Singapore. This is significant to advance the international collaborative phase III clinical trial, that is co-lead with Dr Raghib Ali, Eva Segelov and Toh Han Chong from UK, Australia and Singapore respectively, as most Singapore government academic funding cannot be used outside of Singapore.
The ASCOLT study is the first to evaluate the effectiveness of the cheap, over-the-counter drug, Aspirin as “adjuvant” secondary prevention therapy for patients with established colorectal cancer - the most prevalent cancer in Singapore. It comes at a critical juncture when the U.S. Preventative Services Tasks Force is considering amending its recommendations for Aspirin in healthy people who are also at risk for heart disease – for the primary prevention of cancer, and can be considered one of the most important cancer studies globally, that will contribute new knowledge to our understanding of how Aspirin works at different stages of cancer formation, progression and spread.
While the past decade has witnessed the emergence of strong but indirect evidence pointing to the role of post-operative aspirin use in reducing the risk of recurrence, metastasis and mortality in established colorectal cancer. Although highly promising, this body of evidence is still based on observational results rather than formal experimental testing, and needs to be properly validated in clinical trials.
If successful, the ASCOLT trial, which is evaluating the addition of aspirin to standard cancer therapy, could impact a large volume of patients in both the developing and developed countries as aspirin is widely available, inexpensive and reasonably safe.
“We are most excited to collaborate with Dr Chia and NCCS to address the important role of aspirin in cancer. While preliminary, observational studies suggest that aspirin treatment initiated after diagnosis nearly halves the risk of colon cancer deaths, there exists an urgent need for formal testing to change current clinical practice,” said Eveline Mumenthaler, Director, Rising Tide Foundation for Clinical Cancer Research.
Funding a trial like ASCOLT provides the opportunity to bypass a for-profit model of drug development in support of an academic-lead study as the model of drug development. Whilst the for-profit model of drug development resulted in tremendous innovation and produced an exciting array of new therapeutics, the model is failing people from lower-income countries who have limited access to new drugs. For example, new treatments for Hepatitis C, costs an estimated USD $80,000 per patient, and new anti PD1 immunotherapies recently approved for lung and skin cancer, costs more than USD $10,000 per month.
“As Aspirin is highly cost-effective, should the results prove positive, it will change how colon cancer is managed and could literally, save thousands of lives globally each year”, added Eveline Mumenthaler.
Dr Chia is equally convinced that “access” to good healthcare is a human right and can serve as a stabilising force for society. He said, “Humanity and society has in the past benefited immensely from the advances in scientific knowledge. For example, tuberculosis screening and treatments have allowed high-density urban living to develop, while epidemiology research has helped to pinpoint and control the spread of infectious outbreaks, such as cholera, measles and SARs. Vaccination against polio has also prevented an estimated 10 million childhood disabilities. As academics, we strongly believe that medical research has tremendous potential for furthering the public good.”
With aspirin considered one of the most exciting areas of cancer research whereby the National Cancer Institute USA labelled the use of aspirin to treat cancer as one of the most “provocative questions that needed to be answered in 2012, this Singapore-led study has already been cited at many prestigious international cancer conferences and journals, and is keenly followed by many researchers as one of the most eagerly anticipated trials.
To-date, the trial has already recruited approximately 800 patients and is on track to reach its target of 1200 patients. It will continue to recruit patients from close to 60 hospitals in China, India, Indonesia, Malaysia, Hong Kong, Taiwan, Korea, Saudi Arabia, Singapore, Australia and New Zealand. Beside the funding support from RTFCCR, the study is also supported by the SingHealth Foundation, Lee Foundation, Lee Kim Tah Foundation, NCC Research Fund and the Silent Foundation.
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