Word: coxes
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Dates: during 2000-2009
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Ironically, the trial that exposed the heart risks of COX-2 inhibitors was a cancer experiment, designed to test whether Vioxx or Celebrex could prevent the recurrence of colon cancer. It was halted before any conclusion could be reached. The situation was even more frustrating for patients in a second trial. There, scientists did indeed find a lower recurrence of colon tumors in patients taking Vioxx. "There was a reduction in adenoma recurrence," notes the study's lead author, Dr. Robert Bresalier of MD Anderson Cancer Center. "How that balances with the potential risk remains to be seen...
...after every advantage I could. My surgeon, Dr. Nasser Altorki, chief of thoracic surgery at Weill Cornell Medical Center in New York City, is both a top esophageal specialist and a researcher. He has been investigating--along with my oncologist, Dr. Roger Keresztes, also at Weill--whether COX-2 inhibitors have a role in making treatment more effective and in keeping the disease at bay. Celebrex would be taken during the chemotherapy phase of treatment--in my case, Taxol and Carboplatin. After chemo, I was to take 800 mg of Celebrex (that's two to four times the normal dose...
Scientists initially became interested in the COX-2 enzyme because it's found in so many cancer cells. When active, COX-2 produces a chemical called a prostaglandin that helps keep the stomach lining healthy. It also helps the kidney and blood platelets function properly. In tumors, however, prostaglandin becomes a bad actor, an evil conspirator that helps build the new blood supplies that tumors need to grow. COX-2 also makes cancer cells more resistant to the body's immune response and more resistant to drugs. What would happen, scientists wondered, if you suppressed the COX-2 enzyme with...
...COX-2's prospects as a cancer fighter continue to intrigue scientists. "Clinically, we are still at the beginning," says Dr. Steven Dubinett, director of the thoracic oncology program at UCLA Medical School. "It would really be a travesty if we were unable to continue." Dubinett says about 10% of his studies' participants dropped out. He is investigating whether Celebrex can prevent cancer, but he faces a real dilemma: How can he give to otherwise healthy people a drug that might not work and might increase their risk of heart attack? "It's going to make it very difficult...
Altorki's bigger fear is that the Vioxx scare will deter researchers from doing enough work on COX-2 to understand its true role in cancer. "If we do these studies and they show no evidence of efficacy, then I'm wrong. I'll get off that train and get on another," he says. "But it's important that we find...