[Cyclooxygenase(COX)-2-inhibition in the prevention and treatment of colorectal carcinoma].
Epidemiological studies have found that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a lower risk of colorectal cancer (CRC). Cyclooxygenase (COX)-2 expression is present in colorectal cancer and overexpression is associated with metastases and poorer prognosis in multivariate analysis. NSAID treatment results in a reduction of the incidence of colorectal adenoma in patients with familial adenomatous polyposis, in patients with a history of colorectal adenomas and in patients with a history of CRC. Pre-clinical research shows that COX-2 expression is associated with cell proliferation, angiogenesis, apoptosis inhibition and local immune-down modulation. An anticarcinogenic effect has been shown specifically in selective COX-2 inhibitors in animal models. Selective COX-2 inhibitors have fewer adverse effects than the non-selective NSAIDs and are promising chemopreventative and chemotherapeutical agents. The effects of selective COX-2 inhibition in the prevention of and treatment for colorectal carcinoma will be investigated in clinical randomized multicentre trials.
Tuynman
J B
JB
Sint Lucas Andreas Ziekenhuis, locatie Lucas, afd. Heelkunde, Amsterdam. j.b.tuynman@amc.uva.nl
Hulscher
J B
JB
Steller
E Ph
EP
van Lanschot
J J
JJ
Richel
D J
DJ
D000236:Adenoma / Q000453:epidemiology / Q000517:prevention & control; D011125:Adenomatous Polyposis Coli / Q000150:complications / Q000453:epidemiology; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000201:enzymology / Q000517:prevention & control*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors* / Q000378:metabolism; D008565:Membrane Proteins; D009362:Neoplasm Metastasis; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases