What factors do you use when considering the addition of celecoxib to adjuvant chemotherapy for patients with stage III colon cancer, given CALGB/SWOG 80702 trial results?

Based on the 80702 results, I have started checking for PI3K mutations. In patients with tumors that have a PI3K mutation, I especially recommend celecoxib or aspirin for secondary prevention. However, there are separate data that aspirin may be helpful for primary prevention of polyp formation. Thu...

Since CALGB/SWOG 80702 did not show a benefit from adding celecoxib to adjuvant therapy, I do not recommend its use for all patients. However, subsequent analyses suggest that celecoxib may provide benefit in patients with positive ctDNA or PIK3CA mutations, though these findings require validation....

While the recent ALASCCA trial (Martling et al., PMID 40961426) provides evidence for the benefit of low-dose adjuvant aspirin in PI3K-altered colorectal cancer, unresolved questions remain for the optimal selection and treatment of patients in the adjuvant setting.

For both colon and rectal cancer, ...