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Is COX-2 a 'collateral' target in cancer prevention?

K Kashfi1, B Rigas

  • 1Department of Physiology and Pharmacology, City University of New York Medical School, NY 10031, USA.

Biochemical Society Transactions
|July 27, 2005
PubMed

Insights

Non-steroidal anti-inflammatory drugs (NSAIDs) show promise in preventing colon cancer. However, research suggests that targeting cyclo-oxygenase-2 (COX-2) alone may not be the most effective strategy, necessitating exploration of alternative targets.

Area of Science:

  • Oncology
  • Pharmacology
  • Molecular Biology

Background:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are known to prevent various cancers, including colon cancer.
  • The mechanism involves inhibition of the eicosanoid pathway, with a focus on cyclo-oxygenase (COX) enzymes.
  • Overexpression of COX-2 and increased prostaglandin E2 levels in cancers supported clinical trials for COX-2 inhibitors in cancer prevention.

Purpose of the Study:

  • To evaluate the efficacy of COX-2 inhibitors for cancer prevention.
  • To investigate the role of COX-2 as a target for cancer prevention.
  • To explore alternative targets beyond COX-2 for cancer prevention strategies.

Main Methods:

  • Review of existing evidence on NSAIDs and COX-2 inhibitors in cancer prevention.
  • Analysis of COX-2 expression in pre-malignant and malignant colon tissues.
  • In vitro studies assessing NSAID efficacy independent of COX-2.
  • Clinical data analysis from studies involving COX-2 inhibitors and NSAIDs in conditions like familial adenomatous polyposis.

Main Results:

  • COX-2 is not consistently expressed in early pre-malignant lesions (aberrant crypt foci) or in a majority of adenomas.
  • In vitro data indicate that NSAIDs can prevent cancer independent of COX-2.
  • COX-2 inhibitors have shown modest effects, sometimes weaker than traditional NSAIDs, and possess COX-2-independent activities.

Conclusions:

  • COX-2 may not be the sole or optimal target for cancer prevention.
  • Limitations and cardiovascular side effects associated with COX-2 inhibitors warrant caution.
  • The need to explore multiple COX-2-independent targets for developing effective cancer prevention strategies is highlighted.

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