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They try Celebrex on cancer

            TEL AVIV - MedPage Today noted the selective Cox-2 inhibitor Celebrex is effective in reducing recurrence of benign or precancerous adenomas in patients at a high risk of sporadic colorectal cancer, two large chemoprevention trials found. One investigator, Dr. Nadir Arbor, of Tel Aviv Sourasky Medical Center , called it "proof of principle that chemoprevention is feasible" in sporadic colon cancer. Dr. Arbor presented results of the international Prevention of Sporadic Adematous Polyps (PreSAP) trial at the American Association for Cancer Research meeting.

Dr. Monica Bertagnolli, of the Dana-Farber Cancer Institute and Harvard Medical School presented results of the Adenoma Prevention with Celebrex ( APC ) trial. Both trials showed an excess of cardiovascular events in the Celebrex arms versus placebo; however, because the cardiovascular risk associated with Cox-2 inhibitors was revealed after the studies started, neither was powered to evaluate the issue, nor was cardiovascular safety a predetermined endpoint.

            That said, Dr. Raymond DuBois, of the Vanderbilt-Ingram Cancer Center in Nashville , who wasn’t involved in the studies, noted the majority of the risk appears to be in patients with a history of cardiovascular events prior to enrollment in the trial. If that is the case, patients may be stratified based on risk, and those who have an elevated cardiovascular risk wouldn’t be given the drug, he suggested.

            `Both trials involved patients who already had benign or precancerous adenomas removed and were likely to develop more polyps. In the Adenoma Prevention with Celebrex trial, 679 patients were randomized to placebo, 685 to 200mg of Celebrex twice daily, and 671 to 400mg of Celebrex twice daily. Patients were stratified by aspirin use, which included 31% of participants. Patients were evaluated with colonoscopies at one and three years, and 89% of study participants had the one-year check-up, as did 76% at three years. Of those, 60.6% of placebo patients had new adenomas detected at one of those times.