SUNDAY, June 1 (HealthDay News) -- A widely prescribed pain
reliever may one day have value in helping to prevent lung
cancer.
Researchers report that Celebrex (celecoxib), the last remaining
cox-2 inhibitor on the U.S. market, may reduce levels of a
biomarker indicating risk for this deadly disease. The team
presented its findings Sunday at the American Society of Clinical
Oncology annual meeting in Chicago.
They stressed that this doesn't mean people should start taking
the drug for this reason, as Celebrex has noted cardiovascular side
effects, albeit effects that were not seen in this short-term
study.
"This is a very early study," said Dr. Shakun Malik, director of
the lung cancer program at Georgetown's Lombardi Cancer Center, in
Washington, D.C. "It hasn't shown any effect on actual lung cancer.
All it is showing is that it affects biomarkers. The hypothesis is
that if biomarkers are affected, it will help, but we haven't shown
that as of yet."
The researchers agreed.
"We cannot sit here and say that taking celecoxib is going to
prevent lung cancer," said study author Dr. Edward S. Kim, M.D., an
assistant professor of thoracic head and neck medical oncology at
the University of Texas M.D. Anderson Cancer Center in Houston.
"What we do know was that Celebrex, when taken over a three- or
six-month period, was safe to administer even at a higher dose of
800 milligrams daily."
"We certainly need to move forward with prospective validation,"
added Kim, who spoke at a Sunday news conference. In particular,
researchers need to verify if reductions in biomarkers actually
translate into a reduction in the risk of developing malignancies
in the lung.
"It's too early to tell, but we're definitely interested in
other trials to see how they make out with survival,' said Dr.
Karen Reckamp, an assistant professor of medicine at City of Hope
Cancer Center in Duarte, Calif.
Lung cancer is a notoriously difficult-to-treat disease, largely
because it's usually not caught in its early stages.
"Lung cancer is an extraordinarily challenging tumor type,"
confirmed Dr. Howard Sandler, moderator of the news conference and
a professor of radiation oncology and urology at the University of
Michigan.
Prevention, therefore, becomes key. Quitting smoking or never
smoking, of course, greatly reduces the risk for this disease. But
there are people who beat the odds even if they smoke, just as
there are nonsmokers who do develop lung cancer.
"We need to continue to refine what a high-risk population is,
both clinical and biological characteristics, and that leads us
into biomarkers," Kim said. The researchers were primarily
interested in how Celebrex might affect Ki-67, a protein that may
be related to cell proliferation.
The cox-2 enzyme is expressed in both precancerous lesions in
lung tissue, as well as in lung cancer, and it has an inflammatory
aspect that can stimulate more cell growth within the lung.
This study involved more than 200 patients, all of whom had a
history (current or prior) of a greater than 20-pack-years
cigarette habit. All participants underwent biopsies at the opening
of the study, at three months and again at six months.
They were then randomized to take either Celebrex or a placebo
for three months, after which they either continued on that course
or switched to the other arm.
Over three months, high-dose Celebrex (400 milligrams twice a
day) did reduce expression levels of Ki-67, as well as the cox-2
enzyme and a third biomarker, NF-kappa-B.
The effect was seen in both current and former smokers but was
stronger in current smokers, Kim said.
No cardiac side effects were seen in the group, although
previous research showed a benefit to Celebrex in reducing colon
cancer but, at the same time, a significant increase in adverse
events.
Kim hopes that future studies will identify patients at higher
risk for heart problems (the greatest risk factor is age), and take
that into account. It's also unclear at this point how long
individuals should take Celebrex.
As for patients who already have the disease, Kim said, "I hope
we can keep you alive until you have a heart attack, because that
means we have treated your lung cancer very well."
Another study also presented at the meeting found that PET/CT
(positron emission tomography/computed tomography) imaging more
accurately staged lung cancer cases, sparing more patients from
inappropriate surgery.
PET imaging identified 14 percent of patients who had cancer too
advanced for surgery, while conventional work-ups only identified 7
percent of such patients for whom surgery would have been
inappropriate.
"PET can replace conventional tagging in early stage non-small
cell lung cancer," said study investigator Dr. Donna E. Maziak, of
the Ontario Clinical Oncology Group in Hamilton, Ontario.
More information
Visit the
National Cancer Institute for more on lung
cancer.