title: Effect of celecoxib plus standard chemotherapy on serum levels of vascular endothelial growth factor and cyclooxygenase-2 in patients with gastric cancer.
abstract: Elevated serum levels of vascular endothelial growth factor (VEGF) and cyclooxygenase-2 (COX-2) are associated with poor prognosis in patients with gastric cancer. Little is known regarding the clinical benefits of combining celecoxib, a selective inhibitor of COX-2, with standard chemotherapy regimens for the treatment of gastric cancer patients. In this study, we investigated the effect of the combinatorial use of celecoxib with standard chemotherapy on the serum levels of VEGF and COX-2 in patients with gastric cancer. In our study, 80 patients with gastric cancer who underwent laparoscopic radical surgery were randomized into two groups, the combination [celecoxib plus standard oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX4) chemotherapy, n=40] and the FOLFOX4 alone (n=40) groups. In the combination group, celecoxib was orally administered to the patients (400 mg, twice daily). The serum levels of VEGF and COX-2 were measured by ELISA prior to and following surgery. We detected no significant difference in the serum levels of VEGF and COX-2 between the combination and FOLFOX4 alone groups prior to chemotherapy (P>0.05). However, after 6 cycles of chemotherapy, there was a greater decrease in the serum levels of VEGF and COX-2 in the combination group compared to those in the FOLFOX4 group (P<0.01). In addition, the serum levels of VEGF and COX-2 were closely correlated in patients with gastric adenocarcinoma prior to treatment. Our data indicated that, when combined with standard chemotherapy, celecoxib may reduce the serum levels of VEGF and COX-2, suggesting that COX-2 inhibitors may be of therapeutic value through the inhibition of tumor angiogenesis and the prevention of recurrence or metastasis. Thus, celecoxib may be a useful adjuvant agent to standard chemotherapy in patients with advanced gastric cancer.
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Su
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Wankun
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.affiliation: Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.
authors.forename: Qingchuan
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, P.R. China.
authors.forename: Hua
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of General Surgery, General Hospital of Lanzhou Military Region, Lanzhou, Gansu 730050, P.R. China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Liu
keywords: celecoxib; cyclooxygenase-2; gastric cancer; therapy; vascular endothelial growth factor