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[Cyclooxygenase 2 and breast cancer. From biological concepts to clinical trials]
Jean-Paul Guastalla1, Thomas Bachelot, Isabelle Ray-Coquard
1Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon. guastall@lyon.fnclcc.fr
Abstract:
Cyclooxygenases (Cox) are prostaglandin synthetase enzymes which play a key role in mammary carcinogenesis. Several connections were demonstrated between Cox and a few oncogenes (v-src, v-Ha-ras, HER-2\neu, Wnt, p53 mutated), alimentary products (PUFAs), transcription factors (c-jun and c-fos), proapoptotic proteins [Bax et Bcl-x(L)] or antiapoptotic (Bcl-2), CYP19 aromatase gene, NFkappaB receptor (RANKL), angiogenesis (via VEGF, TXA2, oxid nitric synthetase, alphaVbeta3 integrin receptor), peroxisome gamma proliferator receptor (PPARgamma) and its ligand PGJ2 and with antitubuline chemotherapy drugs. No correlation of Cox2 expression with hormonal receptors was shown. In epidemiologic studies there is evidence of breast cancer risk reduction for women who take AINS for a lon time. Alimentary factors like resveratrol or insaturated fat acid reduce Cox2 expression in animal and could be investigated in human studies. Clinical trials are planed with the anti Cox2 celecoxib for breast cancer prevention, in adjuvant setting, in metastatic situation combined with exemestane or antitubulin drugs or in neoadjuvant therapy.
Insights
Cyclooxygenases (Cox) are key in breast cancer development. Nonsteroidal anti-inflammatory drugs (NSAIDs) and dietary factors may reduce breast cancer risk by inhibiting Cox enzymes.
Area of Science:
- Biochemistry
- Oncology
- Molecular Biology
Context:
- Cyclooxygenases (Cox) are crucial prostaglandin synthetase enzymes implicated in mammary carcinogenesis.
- Research has established links between Cox enzymes and various factors including oncogenes, dietary products, transcription factors, and apoptosis regulators.
Purpose:
- To explore the multifaceted roles and associations of Cyclooxygenases (Cox) in the context of breast cancer.
- To review the evidence linking Cox enzymes to oncogenes, cellular pathways, and potential therapeutic interventions.
Summary:
- Cox enzymes are linked to oncogenes (e.g., v-src, HER-2/neu), PUFAs, transcription factors (c-jun, c-fos), apoptosis regulators (Bax, Bcl-x(L), Bcl-2), CYP19 aromatase, NFkappaB receptor (RANKL), and angiogenesis factors (VEGF, TXA2).
- No correlation was found between Cox2 expression and hormonal receptors. Epidemiological studies suggest reduced breast cancer risk with long-term NSAID use.
- Dietary factors like resveratrol and unsaturated fatty acids may decrease Cox2 expression, warranting further human studies. Clinical trials are planned for celecoxib in breast cancer prevention and treatment.
Impact:
- Highlights the significant role of Cox enzymes in breast cancer pathogenesis and progression.
- Identifies potential therapeutic targets and preventive strategies, including NSAIDs and dietary modifications.
- Informs future clinical trials investigating Cox inhibitors for breast cancer prevention and therapy.
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