COX-2 inhibitors have therapeutic potential in pancreatic cancer

In a small pilot study of 17 patients with advanced heavily pretreated pancreatic cancer, the combination of celecoxib and 5-fluorouracil (5-FU) produced “durable objective responses,” researchers report in the July 1st issue of the journal Cancer.

“The data presented are very preliminary and based on a small series; however, they point to the possibility that adding COX-2 enzyme inhibitors may enhance the efficacy of standard chemotherapy in advanced pancreatic cancer without increasing toxicity,” lead author Dr. Michele Milella told Reuters Health.All 17 patients had progressive advanced pancreatic cancer after gemcitabine-based chemotherapy. They were treated with oral celecoxib (400 mg twice daily) and 5-FU (200 mg/m? per day by protracted IV infusion), both given continuously for 9 months in the absence of disease progression or unacceptable toxicity.Dr. Milella and colleagues from the Regina Elena National Cancer Institute in Rome, report that two patients had partial responses lasting 23 and 68 weeks, respectively and 2 others saw their disease stabilize for 10 and 13 weeks, respectively, for an overall response rate of 12%.”To observe long-lasting disease control — more than 1 year in one patient- – is quite unusual in this setting and may profoundly affect patients’ quality of life,” Dr. Milella said.For the entire group, the median time to disease progression was 8 weeks and the median overall survival was 15 weeks, which is “encouraging,” she and colleagues note in their report.Overall, treatment-related toxicity was “minimal and manageable, making this combination very attractive in an essentially palliative setting, such as advanced pancreatic carcinoma,” the authors write. Four patients discontinued treatment due to upper gastrointestinal tract toxicity.”While these results cannot be considered definitive, we believe they should prompt further research on COX-2 inhibitors as therapeutic agents in pancreatic cancer,” Dr. Milella added.(Source: Cancer 2004;101:133-138: Reuters Health: Megan Rauscher: Oncolink: July 2004)