A study published in the Journal of the National Cancer Institute (Dec. 15, 2010) shows that the commonly prescribed pain medication celecoxib (Celebrex) significantly reduces the incidence of non-melanoma skin cancers in people at high risk for these tumors.  Celebrex has antiangiogenic, or cancer starving, properties.

Non-melanoma skin cancers, including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most commonly diagnosed cancers in the U.S. While not typically lethal, these cancers cause significant discomfort and disfiguration and are a substantial economic burden to the U.S. healthcare system. The cost of non-melanoma skin cancer is estimated to be more than $1.4 billion annually.

The study, conducted by Craig Elmets, M.D. and colleagues in the Department of Dermatology at the University of Alabama, Birmingham, involved 240 people with extensive skin lesions called actinic keratoses (AK), a type of premalignant condition caused by chronic and excessive sun exposure. AK lesions are precursors for SCC or BCC. Patients were randomly assigned to receive 200 mg of celecoxib or a placebo twice daily for 9 months. The celecoxib dose used is the same prescribed to treat arthritis.

Patients who took celecoxib had an approximately 60% reduction in the number of non-melanoma skin cancers after 11 months, compared with those who received the placebo. The chemopreventive effects of celecoxib occurred quickly after initiation of therapy.  By 9 months, patients who received celecoxib had fewer total skin cancers than those in the placebo group, and as soon as 3 months (the first follow-up visit) there were fewer BCCs found in the celecoxib group. There were no significant differences in side effects between the two treatment arms.

These results indicate the celecoxib may be useful for chemoprevention in people at high risk for developing non-melanoma skin cancers due to sun damage. Future studies should evaluate whether lower doses of celecoxib may be just as effective, and whether celecoxib could be used for skin cancer chemoprevention in lower-risk populations.

Celecoxib, an inhibitor of the enzyme cyclooxygenase 2 (COX-2), has anti-inflammatory and anti-tumor activity, and has been shown to suppress the growth of tumor blood vessels (angiogenesis). The drug was chosen for the study because there is epidemiological evidence that people who take large doses of non-steroidal anti-inflammatory drugs (NSAIDs) such as celecoxib, have a lower incidence of non-melanoma skin cancers, particularly SCC. Celecoxib is also used as chemoprevention for colon cancer in people who have genetic colon polyps.

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