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Non-steroidal anti-inflammatory drugs in cancer prevention and therapy

Fiorella Guadagni1, Patrizia Ferroni, Raffaele Palmirotta

  • 1Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy.

Anticancer Research
|November 1, 2007
PubMed

Insights

Non-steroidal anti-inflammatory drugs (NSAIDs) show promise for cancer chemoprevention. However, optimal use is unclear, and cardiovascular risks limit general application, especially for coxibs.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Long-term non-steroidal anti-inflammatory drug (NSAID) use is supported by evidence for cancer chemoprevention.
  • Clinical application is hindered by unanswered questions regarding optimal drug choice, dosage, duration, and mechanisms of action.

Purpose of the Study:

  • To review the efficacy and limitations of NSAIDs in cancer chemoprevention.
  • To discuss the implications of cardiovascular toxicity, particularly with coxibs, on NSAID use.
  • To explore the potential benefits in genetically susceptible populations.

Main Methods:

  • Review of existing clinical and experimental evidence on NSAIDs for cancer chemoprevention.
  • Analysis of data concerning cardiovascular toxicity of NSAIDs, including coxibs.
  • Evaluation of NSAID utility in hereditary cancer syndromes.

Main Results:

  • NSAIDs demonstrate potential as cancer chemopreventive agents.
  • Cardiovascular risks associated with NSAIDs, especially coxibs, restrict their use in the general population.
  • The benefit-risk profile may favor NSAID use in high-risk individuals with genetic predispositions.

Conclusions:

  • NSAIDs offer a viable strategy for cancer chemoprevention, but require further research for optimal implementation.
  • Cardiovascular safety concerns necessitate careful consideration, particularly for coxibs.
  • Targeted use in genetically susceptible individuals with hereditary nonpolyposis colon cancer (HNPCC) or familial adenomatous polyps (FAP) may be warranted despite potential adverse effects.

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