COX-2: a protein with an active role in gynecological cancers.
OBJECTIVE
Emerging data suggest that COX-2 is involved at various steps of the process of malignant transformation and tumor progression. The current article reviews the latest data linking COX-2 with the various gynecological cancers.


RESULTS
COX-2 overexpression has been reported in most gynecological neoplasms, including breast, cervix, endometrial and epithelial ovarian cancers. COX-2 expression promotes tumor cell proliferation, reduces apoptosis and induces angiogenesis. As a result, tumors expressing COX-2 are reported to exhibit a more aggressive phenotype and clinical behavior. Women whose tumors over-express COX-2 tend to have a lower response to standard therapy and shorter survival times. In-vitro studies have shown that COX-2 inhibitors can inhibit tumor cell growth and reduce angiogenesis.


CONCLUSIONS
On the basis of the current data and the clinical availability of safe inhibitors, COX-2 is a perfect target for cancer prevention and therapy. A number of trials are investigating the benefits of combining COX-2 inhibitors with existing treatment modalities in the management of breast, ovarian and cervical cancers. In addition, large prevention trials are in the planning stage.
Munkarah
Adnan
A
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Department of Pathology, Wayne State University, Karmanos Cancer Institute, Detroit, Michigan 48201, USA. amunkara@med.wayne.edu
Ali-Fehmi
Rouba
R
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D017209:Apoptosis; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy / Q000201:enzymology / Q000517:prevention & control*; D006801:Humans; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000502:physiology*
D020533:Angiogenesis Inhibitors; D016588:Anticarcinogenic Agents; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases