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iLIVER 2022, 1(1): 55-64 https://doi.org/10.1016/j.iliver.2022.03.003
Review | Open Access | Issue | Published: 28 March 2022

Aspirin in hepatocellular carcinoma: Is it an out-of-date or promising treatment?

Show Author's Information Xun Qiua,1,  Fengqiang Gaoa,1,  Kai Wanga,  Zhensheng Zhanga,  Chuxiao Shaoe,  Xiao Xua,b,c,d ( )
Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, 310024, China
NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, 310003, China
Institute of Organ Transplantation, Zhejiang University, Hangzhou, 310003, China
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Lishui Hospital, Zhejiang University School of Medicine, Lishui, 323000, China

1 These authors contributed equally to this work.

Keywords:
Cancer therapy, Hepatocellular carcinoma, Aspirin, Chemoprevention, Oncogenic signaling, Immunometabolic response
Cite this article:
Qiu X, Gao F, Wang K, et al. Aspirin in hepatocellular carcinoma: Is it an out-of-date or promising treatment?. iLIVER, 2022, 1(1): 55-64. https://doi.org/10.1016/j.iliver.2022.03.003
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Abstract Full text About this article

Hepatocellular carcinoma (HCC) is one of the most aggressive human malignancies with a dismal survival rate. Few strategies can effectively prevent the occurrence of HCC. Although immunotherapy has significantly improved HCC-related survival in recent years, this systemic therapy is very expensive and lays a heavy burden on most HCC patients. Aspirin, which is currently one of the most widely used medications in analgesic and cardiovascular diseases, is reported to have anti-tumor effects on HCC. Most importantly, long-term administration of low-dose aspirin does not significantly increase the risk of gastrointestinal bleeding. Owing to its cost-effectiveness and wide use, aspirin can be easily applied as an HCC treatment and is affordable for a wide range of patients. Therefore, deeper understanding and more attention are needed to extend the frontline of aspirin's preventive and therapeutic potential into cancer research and management. In this review, we discuss the preventive effect of aspirin on HCC in the context of different etiological factors, including hepatitis B or hepatitis C virus infection, non-alcoholic fatty liver disease, and alcohol-associated liver disease. The therapeutic role of aspirin in resectable or unresectable HCC management is also discussed. Furthermore, the mechanisms underlying the anti-cancer effects of aspirin on HCC are fully reviewed and discussed in the following two aspects: the effect of aspirin on multi-oncogenic signaling pathways in HCC (e.g., AMPK, Wnt/β-catenin, NF-κB) and aspirin-mediated immunometabolic responses in liver diseases. These findings indicate aspirin is a promising agent for populations at risk and HCC patients to prevent or treat HCC.


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About this article

Aspirin in hepatocellular carcinoma: Is it an out-of-date or promising treatment?

Show Author's information Xun Qiua,1, Fengqiang Gaoa,1, Kai Wanga, Zhensheng Zhanga, Chuxiao Shaoe, Xiao Xua,b,c,d ( )
Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, 310024, China
NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, 310003, China
Institute of Organ Transplantation, Zhejiang University, Hangzhou, 310003, China
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Lishui Hospital, Zhejiang University School of Medicine, Lishui, 323000, China

1 These authors contributed equally to this work.

Abstract

Hepatocellular carcinoma (HCC) is one of the most aggressive human malignancies with a dismal survival rate. Few strategies can effectively prevent the occurrence of HCC. Although immunotherapy has significantly improved HCC-related survival in recent years, this systemic therapy is very expensive and lays a heavy burden on most HCC patients. Aspirin, which is currently one of the most widely used medications in analgesic and cardiovascular diseases, is reported to have anti-tumor effects on HCC. Most importantly, long-term administration of low-dose aspirin does not significantly increase the risk of gastrointestinal bleeding. Owing to its cost-effectiveness and wide use, aspirin can be easily applied as an HCC treatment and is affordable for a wide range of patients. Therefore, deeper understanding and more attention are needed to extend the frontline of aspirin's preventive and therapeutic potential into cancer research and management. In this review, we discuss the preventive effect of aspirin on HCC in the context of different etiological factors, including hepatitis B or hepatitis C virus infection, non-alcoholic fatty liver disease, and alcohol-associated liver disease. The therapeutic role of aspirin in resectable or unresectable HCC management is also discussed. Furthermore, the mechanisms underlying the anti-cancer effects of aspirin on HCC are fully reviewed and discussed in the following two aspects: the effect of aspirin on multi-oncogenic signaling pathways in HCC (e.g., AMPK, Wnt/β-catenin, NF-κB) and aspirin-mediated immunometabolic responses in liver diseases. These findings indicate aspirin is a promising agent for populations at risk and HCC patients to prevent or treat HCC.

Keywords: Cancer therapy, Hepatocellular carcinoma, Aspirin, Chemoprevention, Oncogenic signaling, Immunometabolic response

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Acknowledgements
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Publication history

Received: 21 February 2022
Revised: 11 March 2022
Accepted: 14 March 2022
Published: 28 March 2022
Issue date: March 2022

Copyright

© 2022 The Authors. Published by Elsevier Ltd on behalf of Tsinghua University Press.

Acknowledgements

This work was supported by the Key Research & Development Plan of Zhejiang Province (No. 2019C03050) and Youth Program of National Natural Science Foundation of China (82003248).

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This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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