title: Effect of celecoxib on survival in patients with advanced non-small cell lung cancer: a double blind randomised clinical phase III trial (CYCLUS study) by the Swedish Lung Cancer Study Group.
abstract: BACKGROUND
  Increased expression of cyclooxygenase-2 (COX-2) is common in non-small cell lung cancer (NSCLC) and has been associated with poor prognosis. Experimental and clinical phase II trials have indicated that the addition of the COX-2 inhibitor celecoxib to palliative chemotherapy might increase survival time in patients with advanced NSCLC.
  
  
  METHODS
  We performed a double-blind, placebo-controlled multicentre phase III trial at 13 centres in Sweden. Three hundred and nineteen patients with advanced NSCLC stage IIIB-IV and performance status 0-2 were randomised to receive celecoxib 400mg b.i.d. or placebo in addition to palliative chemotherapy. The primary objective was to compare overall survival. Other end-points were quality of life, progression-free survival, toxicity, cardiovascular events and biological markers. The trial is registered with ClinicalTrials.gov, No. NCT00300729.
  
  
  RESULTS
  Three hundred and sixteen patients were included in the analysis, 158 in each treatment group. Median survival time was 8.5 months. There was no survival difference between the treatment arms. Small but not statistically significant differences in global quality of life and pain were seen favouring the celecoxib group. No increased incidence of cardiovascular events was observed in the celecoxib group.
  
  
  CONCLUSIONS
  This study failed to demonstrate a survival benefit of the addition of celecoxib to palliative chemotherapy.
authors.affiliation: Allergy Centre (Allergicentrum), University Hospital, Linköping, Sweden. andrea.koch@lio.se
authors.forename: Andrea
authors.initials: A
authors.lastname: Koch
authors.forename: Bengt
authors.initials: B
authors.lastname: Bergman
authors.forename: Erik
authors.initials: E
authors.lastname: Holmberg
authors.forename: Christer
authors.initials: C
authors.lastname: Sederholm
authors.forename: Lars
authors.initials: L
authors.lastname: Ek
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Kosieradzki
authors.forename: Kristina
authors.initials: K
authors.lastname: Lamberg
authors.forename: Lars
authors.initials: L
authors.lastname: Thaning
authors.forename: Sven-Olof
authors.initials: SO
authors.lastname: Ydreborg
authors.forename: Sverre
authors.initials: S
authors.lastname: Sörenson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D000068579:Celecoxib; D051546:Cyclooxygenase 2 / Q000378:metabolism; D052246:Cyclooxygenase 2 Inhibitors / Q000494:pharmacology*; D018450:Disease Progression; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011379:Prognosis; D011720:Pyrazoles / Q000494:pharmacology*; D011788:Quality of Life; D013449:Sulfonamides / Q000494:pharmacology*; D013548:Sweden
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D010919:Placebos; D011720:Pyrazoles; D013449:Sulfonamides; D051546:Cyclooxygenase 2; D000068579:Celecoxib