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Findings support chemopreventive effects of celecoxib in former smokers

Mao JT. Cancer Prev Res. 2011;doi:10.1158/1940-6207.CAPR-11-0078.

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Former smokers may benefit from treatment with the Cox-2 inhibitor celecoxib to improve bronchial health, according to a study published in Cancer Prevention Research. These results support previously published data that demonstrated a similar effect among current and former smokers.

“Taken together, these findings strongly suggest that celecoxib can be used as a chemopreventive agent in these high-risk groups,” Jenny Mao, MD, professor of medicine at the University of New Mexico and section chief of pulmonary and critical care medicine at the New Mexico VA Health System, said in a press release.

Mao and colleagues conducted a randomized, double blind, placebo-controlled trial that tested the efficacy of 400 mg celecoxib once daily for 6 months in 101 former smokers aged at least 45 years with 30 or more pack-years of smoking who had abstained from smoking for at least 1 year. The primary endpoint was bronchial Ki-67 labeling index after 6 months; the researchers studied the effect of celecoxib on cellular and molecular events associated with lung cancer pathogenesis.

In a mixed-effects analysis, celecoxib was associated with a greater effect on Ki-67 labeling index compared with placebo (P=.0006). There was also a significant decrease in Ki-67 labeling index among patients assigned to celecoxib compared with placebo (average of 34% vs. 3.8%; P=.04). At 6 months, patients who crossed study arms had decreases in Ki-67 labeling index that related to a reduction and/or resolution of lung nodules, according to CT findings. Levels of plasma C-reactive protein, interleukin-6 mRNA and protein were significantly reduced with celecoxib, and 15(S)-hydroxyeicosatetraenoic acid levels were increased in bronchoalveolar lavage (BAL) samples.

“The baseline ratio of Cox-2 to 15-hydroxyprostaglandin dehydrogenase mRNA in BAL cells was a significant predictive marker of Ki-67 response to celecoxib (P=.002),” the researchers wrote.

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