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Cyclooxygenase-2 Inhibitors in Colorectal Cancer Prevention: Point

Arber, Nadir·2008·Cancer Epidemiology, Biomarkers & Prevention
DOI 10.1158/1055-9965.epi-08-0167
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Abstract

The limited success of current treatments for most advanced common malignancies highlights the importance of cancer prevention. Clinical trials on cyclooxygenase (COX) inhibitor drugs showed the potential of chemoprevention as a strategy for reducing cancer incidence, although not without associated side effects. The attractiveness of these drugs partly stems from an ability to engage multiple mechanisms of action by their potential to influence multiple components of the carcinogenesis pathway, from initiation to progression. There are two isoforms of the COX enzymes. COX-1 is constitutively expressed in normal tissues and serves as a “housekeeper” of mucosal integrity, whereas COX-2 is an immediate early response gene that is highly inducible by neoplastic and inflammatory stimuli. COX-2 is significantly overexpressed in colorectal neoplasms, making it an attractive therapeutic target. The drug market has been revolutionized by the development of preparations targeted selectively against COX-2, and a proof of concept has been achieved. Chemoprevention of colorectal cancer is already possible with celecoxib, but it is still not the ultimate drug of choice especially because of the cardiovascular risk associated with COX-2 inhibitors. Better patient selection and more effective and safer drugs are needed. Celecoxib is probably best used in a subset of individuals at moderate to high colorectal cancer risk and low risk of cardiovascular disease. (Cancer Epidemiol Biomarkers Prev 2008;17(8):1852–7)

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Metadata

Authors
Arber, N.
Affiliations
Integrated Cancer Prevention Center, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Venue
Cancer Epidemiology, Biomarkers & Prevention
Publisher
American Association for Cancer Research (AACR)
Published
2008-08-01
Volume
17
Issue
8
Pages
1852-1857
ISSN
  • 1055-9965
  • 1538-7755
DOI
10.1158/1055-9965.epi-08-0167
Cited by
48
References
1
Language
en

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