Prasugrel and Cancer

Arch Intern Med - Vol. 170 No. 21, November 22, 2010

COMMENTS AND OPINIONS Prasugrel and Cancer

Floyd and Serebruany¹ hypothesized that prasugrel is a potential cancer promoter based on the results of an analysis of the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel–Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38) data performed by the Food and Drug Administration, which reported an increased incidence of solid cancers in 6813 prasugrel-treated patients compared with 6795 clopidogrel-treated patients. In my opinion, the authors' hypothesis that prasugrel might reduce the natural defense against tumor growth and dissemination by inhibiting P2Y₁₂-dependent platelet function is denied by the same argument that the authors used to prove that tumor promotion is not a class effect.
In clopidogrel-treated patients, the fact that the rate of new solid cancers was similar (Clopidogrel vs Aspirin in Patients at Risk of Ischemic Events [CAPRIE] trial²) or lower (Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and . . .
AUTHOR INFORMATION
Author Affiliation: Unità di Medicina III, Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.
Marco Cattaneo, MD