Celebrex May Reduce Levels of Lung Cancer Biomarker

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.

SOURCES: June 1, 2008, news conference with Edward Kim, M.D., assistant professor, thoracic head and neck medical oncology, University of Texas M.D. Anderson Cancer Center, Houston, and Donna E. Maziak, M.D.C.M., Ontario Clinical Oncology Group, Hamilton, Ontario, Canada; Shakun Malik, director, lung cancer program, Lombardi Cancer Center, Georgetown University, Washington, D.C.; Karen Reckamp, assistant professor, medicine, City of Hope Cancer Center, Duarte, Calif.; June 1, 2008, presentations, American Society of Clinical Oncology annual meeting, Chicago