Jewish World Review May 31, 2002 / 20 Sivan, 5762

Pain killer zaps lung cancer

By Ed Susman | (UPI)

A commonly prescribed pain killer appears to enhance the ability of anti-cancer drugs to destroy lung tumors, doctors report.

Presenting at the annual meeting of the American Society of Clinical Oncology, researchers said several patients whose cancer was still confined to the lung experienced nearly complete remission of malignancies when taking the drug celecoxib in combination with standard chemotherapy. In addition, all of the 16 patients in the study appeared to experience some benefit from the treatment.

Historically, about 56 percent of patients treated with standard chemotherapy respond to the treatment. In the new study, however, tumor size shrank by at least 50 percent in 12 of 16 patients, and in five of them the cancer virtually vanished. In the other four patients the tumor's growth was halted.

"In about one-third of the patients, at least 95 percent of the tumor was (killed)," said Dr. Nasser Altorki, professor of cardiothoracic surgery at the Weill Medical College of Cornell University, in Ithaca, N.Y. "We observed a complete clinical response in these patients -- we could not see any evidence of the tumor."

Altorki said, however, doctors cannot say the tumor completely disappeared. Upon careful microscopic examination of the patients' lung tissue after surgery, a few viable cancer cells could be identified.

In the study, the patients underwent surgery after six weeks of chemotherapy to remove what remained of the tumors from the diseased lungs.

Celecoxib (Celebrex, marketed by Pharmacia and Pfizer pharmaceutical companies) targets COX-2, an enzyme that is overproduced in inflammatory diseases such as arthritis and in most cancers.

In addition to arthritis pain, celecoxib is also approved for use against certain precancerous growths associated with hereditary forms of colon cancer. Celecoxib, by inhibiting COX-2, disrupts the cascade of molecular events that can lead to cancer growth.

"Results of this kind are encouraging enough for us to go further with a larger trial in which we compare two treatments -- one with celecoxib and one without it," Altorki said.

Dr. Michael Gordon, associate dean for research at the University of Arizona-Phoenix, said, "The results are interesting, but you have to realize that those results are within the range of a Phase II study, done at a single institution, with selected patients."

If the findings "are replicated in other studies with similar patients," Gordon continued, "it may change treatment for patients with early stage lung cancer. Currently those patients don't universally have chemotherapy before surgery, because that means putting patients through several weeks of toxic treatment."

Altorki said in lung cancer -- a disease that kills more than 150,000 Americans each year -- treatment with standard drugs and surgery still means less than 40 percent of patients survive for five years. He suggested treatment enhanced with celecoxib might enhance chances of long-term survival, but studies still have to be performed.

Altorki also said, based on current knowledge, it would not be prudent to use celecoxib or other COX-2 inhibitors to attempt to prevent tumors -- especially at the higher than usual doses employed in his trial.

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