Aspirin plus FOLFOX for colorectal cancer management: A promising alternative for clinical trial in Africans with the disease

Colorectal cancer (CRC) has disproportionately overburden Africans with advanced stage at diagnosis and higher mortality rate due in part to issues that include grossly inadequate resources for management and poor understanding of the pathobiology of the disease. Accumulating evidences support the effectiveness of Aspirin in prevention and inhibition of CRC occurrence and cellular growth respectively. The utilisation of 5-fluorouracil (5-FU)-based regimens which include folinic acid, 5-FU and oxaliplatin (FOLFOX) combination in CRC management have not completely halt the distant recurrences and poor prognosis of CRC. In this study, we highlighted evidences that prove Aspirin plus FOLFOX to be promising alternative for clinical trial in Black men with CRC. Our study aims in this research were: to identify the expression pattern of BIRC7 in human CRC cells, SW480 cell line and N-methyl-N-nitrosourea (NMU)-induced CRC in rat; to determine the relationship between BIRC7 and BCL2, p53, PDL-1, MSH1, PMS2, DARC and Annexin V expression in CRC. to examine the efficacy of Aspirin plus neoadjuvant FOLFOX on the BIRC7 in CRC cells in-vivo in rat. Results show significant (P = 0.0001) expression of the BIRC7 in the CRC tissues compared to normal sections. When comparing this expression with Data from TCGA data bank, we observed a significant increase in BIRC7 expression in Caucasian than the Black and Indian and The expression pattern of the BIRC7 was significantly higher (P = 0.0001) in CRC not otherwise specified compared to mucinous CRC histology. The SW480 cell line show increased expression of the BIRC7 protein in-vitro. There was significant expression of the BIRC7 in the NMU-induced CRC cells compared the normal colonic lesion. There was increased expression of the BCL-2 and reduced expression of p53 in the human CRC cases and in the NMU-induced CRC cells model. There was increased expression of the Annexin V, absence of the MSH1, PMS2, PDL1 and DARC protiens in the CRC sections. Aspirin plus FOLFOX may serve as an important adjuvant treatment component for colorectal cancer metastasis and local recurrence in Blacks, Caucasian and Asians. There is need to explore the potential of Aspirin plus FOLFOX for clinical trial in colorectal cancer management in Blacks and other population using approach from our findings. Citation Format: Faruk Mohammed, Sani Ibrahim, Sirajo Mohammed Aminu, Ahmed Adamu, Adamu Abdullahi, Abdulmumini Hassan Rafindadi, Yawale Iliyasu, John Idoko, Abdullahi Jubril Randawa, Mohammed Sani Shehu, Atara Ntekim, Abdullahi Mohammed, Aishatu Maude Suleiman, Yahaya Ukwenya, Khalid Zahir Shah, Ahmad Bello, Sani Abubakar, Kasimu Umar Adoke, Cheh Augustin Awasum, Ahmad Mai, Hussaini Yusuf Maitama, Dauda Maigatari. Aspirin plus FOLFOX for colorectal cancer management: A promising alternative for clinical trial in Africans with the disease [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 720.