Prostaglandin inhibitors and the chemoprevention of noncolonic malignancy.
Much has been learned about the role of NSAIDs as cancer preventives through epidemiologic and experimental studies. The pathways of carcinogenesis in the gastrointestinal tract are initiated by many different genetic, environmental, infective, and lifestyle factors. It is possible that the final common pathway of all these malignancies may have some common features. It is conceivable that head and neck, esophageal, gastric, and colorectal epithelial carcinogenesis all are influenced by or require COX-2 up-regulation as a step toward transformation. Intuitively, it is possible that selective COX-2 inhibitors may have a preventive role in all these epithelial malignancies. Today's challenge is to translate this information into clinical trials to define what role, if any, COX inhibition might play in the prevention of these malignancies.
Krishnan
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Division of Hematology and Oncology, Department of Internal Medicine, James H. Quillen Veterans Administration Medical Center, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA. krishnak@etsu.edu
Brenner
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D000230:Adenocarcinoma / Q000503:physiopathology / Q000517:prevention & control*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000503:physiopathology / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000517:prevention & control*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008565:Membrane Proteins; D011448:Prostaglandin Antagonists / Q000627:therapeutic use*; D011451:Prostaglandin-Endoperoxide Synthases; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011448:Prostaglandin Antagonists; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases