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Aspirin + eflornithine is a combination of two small molecule drugs, acetylsalicylic acid (aspirin) and eflornithine (also known as difluoromethylornithine or DFMO). Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that irreversibly inhibits cyclooxygenase enzymes, reducing prostaglandin synthesis and exerting anti-inflammatory, analgesic, antipyretic, and antiplatelet effects. Eflornithine is an irreversible inhibitor of ornithine decarboxylase, the rate-limiting enzyme in polyamine biosynthesis; this inhibition disrupts cell proliferation and has been used for both antiparasitic therapy (notably African trypanosomiasis) and cancer chemoprevention. The combination has been investigated primarily for chemoprevention in high-risk populations for colorectal cancer—especially to reduce the recurrence of adenomas in patients with a history of advanced colorectal tumors. Clinical studies suggest that while DFMO-based combinations can lower adenoma recurrence rates overall, the specific combination of DFMO (eflornithine) plus aspirin may have an effect comparable to placebo in this setting; other combinations such as DFMO plus sulindac show greater efficacy[2][8]. The mechanism involves dual targeting of polyamine metabolism and inflammatory pathways implicated in tumorigenesis.
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