Randomized Study of a Selective COX-2 Inhibitor in Oral Premalignant Lesions

Oral premalignant lesions are white and/or red patches in the oral cavity that are commonly caused by tobacco and alcohol use. New medicines are needed to prevent these lesions from becoming cancerous. Increased levels of COX-2, a protein that catalyzes the synthesis of prostaglandins, were detected in both oral premalignant lesions and squamous cell carcinomas of the head and neck. Because COX-2 can predispose to cancer by a variety of mechanisms including 1) enhancing angiogenesis, 2) inhibiting programmed cell death and 3) activating tobacco carcinogens, it is regarded as a promising pharmacologic target for cancer prevention. Moreover, selective inhibitors of COX-2 appear to have fewer side effects than traditional nonsteroidal anti-inflammatory drugs.

Based on a series of preclinical studies in the laboratory of Drs. Andrew Dannenberg  and Kotha Subbaramaiah of New York Presbyterian Hospital-Cornell and Strang Cancer Prevention Center, a multicenter clinical trial has been initiated to determine whether a selective COX-2 inhibitor has utility in the treatment of oral premalignant lesions. This study is one of multiple trials in which selective COX-2 inhibitors are being investigated to assess their anti-cancer properties.