title: Targeting the COX-2 Pathway to Improve Therapeutic Response in the Obese Breast Cancer Patient Population.
abstract: Multiple studies have demonstrated that obesity is associated with a worse outcome for all breast cancer subtypes and that obese breast cancer patients do not respond as well as normal weight patients to aromatase inhibitor treatment and chemotherapy. While a number of mechanisms have been proposed to explain this link, recent studies have provided evidence that elevated local cyclooxygenase-2 (COX-2) expression and the resulting increase in prostaglandin E2 (PGE2) production may play an important role. COX-2 upregulation in breast tumors is associated with a poor prognosis, a connection generally attributed to PGE2's direct effects on apoptosis and invasion as well as its stimulation of pre-adipocyte aromatase expression and subsequent estrogen production. Research in this area has provided a strong foundation for the hypothesis that COX-2 signaling is involved in the obesity-breast cancer link, and further study regarding the role of COX-2 in this link is warranted.
authors.affiliation: Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Boulevard, R1800, Austin, TX 78723.
authors.forename: Laura W
authors.initials: LW
authors.lastname: Bowers
authors.affiliation: Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Boulevard, R1800, Austin, TX 78723.
authors.forename: Linda A
authors.initials: LA
authors.lastname: deGraffenried
keywords: Breast cancer; cyclooxygenase-2; obesity; prostaglandin E2