Drug May Help Shrink Tumors
By Delthia Ricks
July 15, 2003
Arthritis remedy Celebrex can boost the effectiveness of chemotherapy for lung cancer, shrinking tumors and cutting off their blood supply, Manhattan scientists report in a study published today.
The small research project, which involved patients with the most common form of the cancer, marks the first time the widely used arthritis medication has proved effective against active tumors. Previous studies suggested the drug is effective at inhibiting cancer development before it starts. In 1999, the Food and Drug Administration licensed Celebrex as a preventive for patients with a rare genetic condition in which pre-cancerous polyps develop into colorectal cancer.
The study is the second this year to validate the concept of blocking the growth of tumor blood vessels, known as anti-angiogenesis. In June, a drug targeting colorectal cancer, was shown effective in extending patient survival when used with standard treatment.
Dr. Nasser Altorki, a professor at Weill Cornell Medical College and the study's chief investigator, reports the lung cancer study in today's Journal of Clinical Oncology.
He and his team tested Celebrex in 29 patients with non-small cell lung cancer, the most aggressive form of the disease. All participants took two pills totaling 800 milligrams each day for seven weeks. (Arthritis patients usually receive a single 200-mg or 400-mg dose daily.)
Conventional intravenous chemotherapeutic agents, paclitaxel and carboplatin, were also administered. Paclitaxel acts on the process of cancer cell division. Carboplatin is a broad spectrum cell toxin. Celebrex shrinks tumors by denying their blood supply.
Altorki concluded that Celebrex, a product of Pfizer Inc., boosts the effects of conventional chemotherapy because it weakens tumors.
He said that 62 percent of the patients got "at least a 50 percent tumor shrinkage" and 24 percent of patients had no remaining evidence of microscopic disease. Drug treatment was followed by surgical removal of tissue affected by the cancer, even in instances where there was an absence of microscopic cells, to ensure that the cancer would not come back.
Eighty percent of lung cancers are caused by smoking, and the disorder is the leading cause of cancer deaths in the United States. The American Cancer Society estimates it will kill 160,000 people nationwide this year.
Martin Stewart, 80, a Manhattan lawyer, has been given a clean bill of health after participation in the study. He initially had what was diagnosed as an inoperable tumor. "I was classic. I smoked from the time I was about 13 years old and I used to smoke about four or five packs a day," he said. "I stopped about 15 years ago." Stewart has resumed working full time.
Adnan Naum, 70, a former geology professor at the University of Baghdad who moved to Manhattan in 1995, was another participant. Even though he had an excellent response to the treatment, doctors removed 60 percent of one lung because the cancer had been so pervasive.
Celebrex is a COX-2 inhibitor. Several medications in this class, including the arthritis drug Vioxx, are being tested as cancer agents.
COX-2 inhibitors block the enzyme cyclooxygenase-2, which is involved in the production of prostaglandins, molecules that play a strong role in inflammatory processes. When cancer is present, prostaglandins stimulate the tumor's growth of tiny feeder vessels that tap into the host's blood supply.
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