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Cyclo-oxygenase 2 inhibition in colorectal cancer therapy
R D Church1, J W Fleshman, H L McLeod
1Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8069, St Louis, MO 63110-1093, USA. churchr@msnotes.wustl.edu
Background:
Cyclo-oxygenase inhibition for the treatment of colorectal neoplasia has been studied with renewed interest since the discovery of cyclo-oxygenase (Cox) 2 and the introduction of specific Cox-2 inhibitors. These drugs have implications for both the prevention of colorectal carcinoma and the potential treatment of the disease.
Methods And Results:
A Medline database search was performed for articles using the keywords "colonic, colon or rectal and neoplasia or cancer" and "cyclo-oxygenase or Cox-2." Cross-references of relevant historical papers were also included. There is substantial evidence that Cox-2 plays a role in the development and progression of colorectal cancer. The specific inhibition of this enzyme has been shown to inhibit cancer growth in in vitro and in vivo models. The mechanisms of action for these effects are poorly understood and potential clinical applications at present remain under investigation.
Conclusion:
Cox-2 inhibitors have great promise as useful additions to current cancer treatments. There is a need for randomized clinical trials to define a role for these drugs in chemoprevention, recurrence prophylaxis, and adjuvant therapy for colorectal and other solid tumours.
Insights
Cyclo-oxygenase-2 (Cox-2) inhibitors show promise for treating and preventing colorectal cancer. Further clinical trials are needed to confirm their role in cancer therapy and prevention.
Area of Science:
- Oncology
- Pharmacology
Background:
- Renewed interest in cyclo-oxygenase inhibition for colorectal neoplasia treatment.
- Discovery of cyclo-oxygenase (Cox) 2 and development of specific Cox-2 inhibitors.
- Implications for colorectal cancer prevention and treatment.
Purpose of the Study:
- To review the role of Cox-2 inhibition in colorectal neoplasia.
- To explore the potential of Cox-2 inhibitors in cancer therapy.
Main Methods:
- Medline database search using keywords: "colonic, colon or rectal and neoplasia or cancer" and "cyclo-oxygenase or Cox-2."
- Inclusion of cross-references from relevant historical papers.
Main Results:
- Substantial evidence indicates Cox-2 involvement in colorectal cancer development and progression.
- Specific Cox-2 inhibition demonstrated efficacy in inhibiting cancer growth in vitro and in vivo models.
- Mechanisms of action remain poorly understood; clinical applications are under investigation.
Conclusions:
- Cox-2 inhibitors hold significant promise as adjuncts to current cancer treatments.
- Need for randomized clinical trials to establish their role in chemoprevention, recurrence prophylaxis, and adjuvant therapy.
- Potential application in colorectal and other solid tumors.