Authors: LesleyAnn Martin Giles L S Davies Marion T Weigel Nadine Betambeau Margaret J Hills Janine Salter Geraldine Walsh Roger A’Hern Mitch Dowsett
Publish Date: 2010/08/10
Volume: 123, Issue: 3, Pages: 829-836
Abstract
Cyclooxygenase 2 COX2 is implicated in the regulation of aromatase transcription in malignant breast tissue and has been considered as a potential target for tissue specific aromatase suppression We initiated a randomised controlled presurgical study of celecoxib versus no treatment in women with primary breast cancer to determine the effects of COX2 inhibition on markers of biological response Postmenopausal women 50–80 years of age with stage I or II primary breast cancer were randomised 21 to receive 400 mg/day celecoxib or no treatment for 14 days prior to surgery A core biopsy was obtained pre and posttreatment Paired baseline and endpoint biopsies were analysed for Ki67 apoptosis COX2 CD31 estrogen receptor ER and progesterone receptor PgR Comparisons between the treatment groups were conducted using the Mann–Whitney test with a twosided 5 significance Of the 25 patients treated 23 had evaluable data and 19 83 were ER positive Overall the geometric mean change in Ki67 the primary end point relative to baseline in the celecoxib arm was −166 P = 0056 The change in the notreatment group was −81 P = 024 There was no statistically significant difference in the change between the two groups Celecoxib did not significantly affect apoptosis COX2 ER or PgR expression There is only modest evidence for a biological effect of celecoxib in primary breast cancer However the trend towards a reduction in Ki67 in ERpositive breast cancer warrants further investigations in a larger cohort of patients
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