Results of a pilot study of the effects of celecoxib on cancer cachexia in patients with cancer of the head, neck, and gastrointestinal tract

Abstract

Background. Animal models suggest that cyclooxygenase-2 (COX-2) inhibitors may be beneficial in suppressing cancer cachexia. We investigated the effect of short-course celecoxib on body composition, inflammation, and quality of life (QOL) in patients with cancer cachexia in a phase II clinical pilot trial.Methods. Eleven cachectic patients with head and neck or gastrointestinal cancer were randomly assigned to receive placebo or celecoxib for 21 days while awaiting the initiation of cancer therapy. Body composition, resting energy expenditure, QOL, physical function, and inflammatory markers were measured on days 1 and 21.Results. Patients receiving celecoxib experienced statistically significant increases in weight and body mass index (BMI), while patients receiving placebo experienced weight loss and a decline in BMI. Patients receiving celecoxib also had increases in QOL scores.Conclusions. This syndrome is distinct from starvation in that it involves preferential wasting of lean body mass (LBM) while visceral proteins are preserved; elevated systemic inflammation, including increased levels of acute phase proteins and inflammatory cytokines; and elaboration of tumor-derived catabolic factors.2 Cachexia remains difficult to treat, with few U.S. Food and Drug Administrationapproved therapeutic options other than megestrol acetate, dronabinol, and oxandrolone.2 These

Randomized Phase III Clinical Trial of Five Different Arms of Treatment in 332 Patients with Cancer Cachexia

“…In selecting the agents, we had originally planned to include the most selective cyclo-oxygenase 2 inhibitor, celecoxib, on the basis of the results observed in our phase II study [16] and in other authors' studies [61][62][63]; however, we eventually decided to not include this drug because of cardiotoxicity safety concerns that emerged in 2005 and that led to the withdrawal of rofecoxib from the market and restriction on the use of celecoxib.…”

Skeletal muscle atrophy: Potential therapeutic agents and their mechanisms of action

“…Out of these inhibitors only two (celecoxib and meloxicam) have been widely used to study Cox2 mediated muscle loss [73,74,77]. [78]. This reflects its effectiveness in treating cancer cachexia.…”

Cancer cachexia, mechanism and treatment

“…There are four studies investigating the relationship between non-steroidal anti-inflammatory drugs (NSAIDs) and cancer cachexia [158][159][160][161] . These studies demonstrated improved quality of life, performance status, inflammatory markers, weight gain and survival.…”