Talking with patients about dying.

n engl j med 367;17 nejm.org october 25, 2012 1651 in this study. Indeed, only 66 patients with mutated-PIK3CA tumors used aspirin after a diagnosis of colorectal cancer and only 3 of them died of colorectal cancer during the follow-up period. Assuming these findings are confirmed in large prospective studies, one may predict that the PIK3CA mutation status of colorectal tumors will become a useful biomarker that may guide adjuvant therapy. Since more than one of six primary colorectal tumors harbors PIK3CA mutations,9,10 targeted use of adjuvant aspirin could have a major effect on the treatment of colorectal cancer. Aspirin may well become one of the oldest drugs to be used as a 21st-century targeted therapy.