Weekly Journal Scan: Platelet thromboxane suppression as the mechanism of the anti-metastatic effect of aspirin

This comment refers to ‘Aspirin prevents metastasis by limiting platelet TXA2 suppression of T cell immunity’, which was published in the Nature, https://doi.org/10.1038/s41586-025-08626-7. Low-dose aspirin has long been a cornerstone of cardiovascular disease (CVD) prevention due to its COX-1-dependent anti-platelet effect.3 However, emerging evidence over the past two decades has suggested that its long-term benefits may extend beyond atherothrombosis prevention, potentially impacting cancer progression and metastasis.4 A large number of observational studies and post hoc analyses of cardiovascular trials have consistently suggested a reduction in cancer mortality—especially through decreased metastasis—in regular aspirin users.4–6 Moreover, a limited number of placebo-controlled randomized aspirin trials have reported reduced cancer incidence or metastatic progression over long-term follow-up.7 However, these chemopreventive effects appeared cancer-type specific. Colorectal cancer, together with other tumours that arise from the gastrointestinal (GI) tract, showed the most consistent benefits,8,9 possibly due to an important role of COX pathways in GI carcinogenesis.4