Chemoprevention backgrounder: Working for a future of cancer chemoprevention

-cell lung cancer, also contain a lot of COX-2, possibly because of the body's natural immune reaction to the cancer. Lotan found this year that, like some retinoids, NSAIDs may be effective in controlling cancer because they push cancerous cells to self-destruct.

In the ongoing placebo-controlled trial, which has accrued 85 patients so far, Kurie takes a biopsy of lung cells before, after and during the six-month study to see if twice-daily 400 milligrams doses of celecoxib can reverse damage due to smoking. "It's a biomarker study in which we will be able to see evidence of activity quickly," he says. "If positive, we will move on to a national study."

Not only is the power of COX-2 inhibitors being tested at M. D. Anderson in the number one cancer killer, lung cancer, but in the second deadliest national cancer - colorectal cancer.

And so far, it already has been proven to have an effect in people who inherit a form of colon cancer known as familial adenomatous polyposis (FAP), in which hundreds of precancerous polyps form in the colon and rectum. In 1999, the Food and Drug Administration (FDA) approved the use of celecoxib for FAP patients, based on work conducted at M. D. Anderson and St. Marks Hospital in London. In the study, led by Patrick Lynch, M.D., celecoxib reduced the number of polyps by 30 percent.

"It was an important event in the field of chemoprevention," says Levin. Colorectal cancer prevention trials do not focus on cancer occurrence, because of time constraints, but rather look at the incidence of adenomatous (glandular) polyps, which are known to increase colon cancer risk.

Based on that study, Lynch, an associate professor in the Department of Gastrointestinal Medicine and Nutrition, is heading another international trial in FAP looking at use of celecoxib combined with eflornithine (DFMO), a drug used to treat African sleeping sickness, but which is suspected of having anti-cancer properties. '"/>

Contact: Nancy Jensen
University of Texas M. D. Anderson Cancer Center

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