Role of Specific COX-2 Inhibitors in Cancer Prophylaxis and Treatment

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Nongnit Teerawatanasuk


Increasing evidence suggests that upregulation of cyclooxygenase-2 (COX-2) gene expression is implicated in colorectal carcinogenesis. Large epidemiologic studies as well as

clinical studies consistently show that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) reduces the relative risk of colorectal cancer. The effect of NSAIDs on chemoprevention and tumor regression has also been demonstrated in a range of

experimental models in animals. Recently, specific COX-2 inhibitors such as celecoxib, rofecoxib, and valdecoxib have been developed and marketed. These compounds have been

shown in several clinical trials to produce fewer gastrointestinal adverse effects than classical

COX inhibitors. To date, celecoxib is the first specific COX-2 inhibitor approved by the       United States Food and Drug Administration (US FDA) for the prophylaxis and treatment of

familial adenomatous polyposis (FAP), a benign colorectal tumor that would eventually progress to malignancy.


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