Celecoxib anti-aromatase neoadjuvant (CAAN) trial for locally advanced breast cancer.
OBJECTIVE
To evaluate the efficacy and safety of combing aromatase inhibitor (AI) and cyclooxygenase-2 (COX-2) inhibitor neoadjuvantly in postmenopausal patients with invasive hormone-sensitive breast cancer.


METHODS
Eighty-two patients were randomly assigned to receive exemestane 25mg daily and celecoxib 400mg twice daily (group A, n=30), exemestane 25mg daily (group B, n=24) and letrozole 2.5mg daily (group C, n=28).


RESULTS
All groups showed clinical responses (58.6% for group A, 54.5% for group B and 62.0% for group C) and decrease in tumor area (61.8% for group A, 58.1% for group B and 55.7% for group C). 3 out of 5 patients with complete clinical response were observed from group A and 2 out of 69 patients operated with pathologic complete response were observed in group C. The mean microscopic tumor size was 2.53 cm for group A, 3.05 cm for group B and 2.10 cm for group C. The differences were only statistically significant when group C was compared with group B (P=0.025). The toxicity profiles among groups were satisfactory.


CONCLUSIONS
AI is effective in treating breast cancer and may be safely used preoperatively. The addition of COX-2 inhibitor may provide additional benefit.
Department of Surgery, University of Hong Kong Medical Centre, Pokfulam, Hong Kong. lwcchow@unimed.hk
Louis Wing-Cheong
LW
Chow
Adrian Yun-San
AY
Yip
Wings Tjing-Yung
WT
Loo
Chi-Kei
CK
Lam
Masakazu
M
Toi
D000368:Aged; D000369:Aged, 80 and over; D000730:Androstadienes / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D000068579:Celecoxib; D002784:Cholesterol / Q000097:blood; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017698:Postmenopause; D011720:Pyrazoles / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D047368:Tumor Burden
D000730:Androstadienes; D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D052246:Cyclooxygenase 2 Inhibitors; D008055:Lipids; D011720:Pyrazoles; D013449:Sulfonamides; D002784:Cholesterol; D000068579:Celecoxib; C056516:exemestane