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Celebrex may help prevent some non-melanoma skin cancers
By Dross at 2010-12-01 01:59
Celebrex may help prevent some non-melanoma skin cancers

 

 New research shows the NSAID Celebrex may help prevent some non-melanoma skin cancers from developing in patients who have pre-cancerous actinic keratoses lesions and are at high risk for having the disease.

The researchers, led by University of Alabama at Birmingham dermatologist and the study's lead author,Craig Elmets, M.D., evaluated the efficacy and safety of celecoxib as a chemo-preventive agent for actinic keratoses. The results were published online Nov. 30, 2010, in the Journal of the National Cancer Institute. It will appear in the print edition of the journal Dec. 15. 

Cutaneous squamous cell carcinomas and basal cell carcinomas are the most common malignancies in the United States. More than 2 million people are diagnosed each year with non-melanoma skin cancer and instances of malignancies are increasing, especially in young people. The direct treatment of these has been estimated to exceed $1.4 billion annually.

Previous research data has suggested that cyclooxygenase 2 is involved in the development of non-melanoma skin cancers. In animal models, the cyclooxygenase 2 inhibitor celecoxib, better known by its brand name Celebrex, inhibits the development of ultraviolet-induced pre-malignant skin papillomas, which are thought to correspond to actinic keratoses, the pre-malignant precursor of non-melanoma skin cancers

Currently, celecoxib is used to relieve pain, tenderness, swelling and stiffness caused by osteoarthritis, rheumatoid arthritis and spinal arthritis. It also is can be used off-label to treat painful menstrual periods and pain from other causes and is used to reduce the number of polyps in the colon and rectum in patients with familial adenomatous polyposis. Celecoxib is in a class of NSAIDs called COX-2 inhibitors.

The double-blind, placebo-controlled trial looked at 240 subjects ages 37 to 87 years with 10 to 40 actinic keratoses at eight U.S. academic medical centers during an 11-month period.

At nine months after randomization, there was no difference in the incidence of new actinic keratoses developed between the placebo group and those receiving celecoxib, which was the primary endpoint of the study. However, compared with the placebo, celecoxib when looked at duing the 11-month visit was highly effective in preventing nonmelanoma skin cancers from developing in subjects who had large numbers of actinic keratoses.

"While celecoxib was not effective in preventing new actinic keratoses the study raises the possibility that the drug is effective in preventing cancer from developing from the precancerous actinic keratoses lesions," Elmets said.

Future studies are planned to establish if other NSAIDs have the same properties as Celebrex as skin-cancer chemopreventive agents. Topical NSAIDs also are being investigated to determine if they can be used to prevent skin cancers.

 

 



1 comment | 2169 reads

by gdpawel on Wed, 2010-12-01 21:51
Celebrex shows potential in preventing some skin cancers, but one expert was quick to note that the drug has been linked in some studies to an increase in the risk for cardiovascular problems. So it isn't yet clear that Celebrex (celecoxib) is an ideal choice to prevent cancers that could be treated by other means.

"We have a lot of different treatments for non-melanoma skin cancers," noted Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City. "I would want more information regarding the mechanism of action of Celebrex, because of the other risks," she said.

The Food and Drug Administration stopped the study early, however, when reports emerged that NSAIDs might increase the risk of heart attacks and strokes.

In an editorial, Drs. Frank Meyskens Jr. and Christine McLaren, both of the University of California, Irvine, said that the finding that Celebrex helped reduce cancers but not precancerous lesions suggests that different mechanisms may be at work during different stages of tumor development.

Any cancer drug can cause potential heart damage, even death, and many doctors do not adequately monitor their patients or manage their care to minimize the health risk, according to a study by M. D. Anderson cardiologists.

Patients and doctors may not be aware of the spectrum of heart problems that can arise from cancer treatment, or know that many of these problems can be managed.

The study, published an issue of the journal Circulation, is the first large-scale review that details. Conducted with nine other M. D. Anderson cardiologists, the study reviews research on the cardiotoxicity of 29 anti-cancer drugs as well as 30 years of experience at M. D. Anderson.

Cardiotoxicity can occur in any patient. Generally speaking, patients most at risk are elderly and have other illnesses, such as diabetes and heart disease. Heart problems can occur during treatment or months and even years after treatment.

Possible solutions include, avoiding certain drugs, lowering drug dosages, administering drugs slower and over a longer period of time, monitoring cardiac health more stringently, avoiding giving some drugs simultaneously, treating cardiac risk factors, use of an echocardiogram during and after cancer treatment, and treating patients with heart failure drugs.

The Anderson researchers found a profile of cardiotoxicity for the most often used anticancer drugs, but it is important to know that every patient has different risk factors that will determine how their hearts handle the treatment. Monitoring and management is key to surviving cancer with a good and lasting heart.

[url]http://jnci.oxfordjournals.org/content/early/2010/11/29/jnci.djq442.abstract[/url]

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