The ASCOLT Study (Aspirin for Dukes C and high risk B COLorecTal cancer) is an international collaborative group randomized clinical phase III trial investigating the utility of low dose aspirin on improving disease free and overall survival in patients with resected Stage III (Dukes C) and high risk Stage II (Dukes B) colorectal cancer (CRC). The trial is led by an international collaboration from Singapore, UK and Australia with co-chairs Chia and Toh (Singapore), Ali (Oxford) and Segelov (AGITG), involving recruitment from about 60 sites in 11 countries or special administrative regions including Singapore, India, China, Taiwan, Hong Kong, Korea, Malaysia, Indonesia, Saudi Arabia, Australia and New Zealand.

This study is the first to evaluate aspirin as adjuvant therapy in established cancers, and has been tipped as one of the most important gastrointestinal cancer studies globally.  In 2012, the National Cancer Institute of U.S listed aspirin’s role in cancer as one of the most provocative questions in cancer research. The Australian Gastrointestinal Trial Group (AGITG) has also recently ranked “Aspirin in Colorectal Cancer” – as the top research priority in gastrointestinal cancer, and has therefore committed to recruiting for ASCOLT.

Overall, the study has recruited more than 740 patients to date.  With the challenges of escalating healthcare costs and an aging population, aspirin may provide an extremely cost-effective means of reducing cancer mortality both in lower-income and developed countries.  Apart from its direct health impact, the ASCOLT trial offers an opportunity to catalyze the formation of a cross-border clinical trial network in our region.