Cyclo-oxygenase 2 inhibition in colorectal cancer therapy.
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.


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.


CONCLUSIONS
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.
Church
R D
RD
Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8069, St Louis, MO 63110-1093, USA. churchr@msnotes.wustl.edu
Fleshman
J W
JW
McLeod
H L
HL
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control; D051546:Cyclooxygenase 2; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D061965:Matrix Metalloproteinase Inhibitors; D008565:Membrane Proteins; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011451:Prostaglandin-Endoperoxide Synthases
D020533:Angiogenesis Inhibitors; D007527:Isoenzymes; D061965:Matrix Metalloproteinase Inhibitors; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases