Cyclooxygenase-2 (COX-2) may be a promising therapeutic target in patients with pancreatic ductal adenocarcinoma (PDAC).
In this study, researchers from Italy evaluated 17 patients with advanced PDAC who had progressive disease after gemcitabine-based chemotherapy.
Patients received oral celecoxib (400 mg twice daily) and protracted intravenous (IV) infusion 5-fluorouracil (200 mg/m2 per day).
Patients were examined weekly for toxicity.
They were also restaged every 6 to 8 weeks for tumor assessment.
The researchers found that asymptomatic transaminase elevation was the most common toxicity.
|Asymptomatic transaminase elevation was the most common toxicity.|
A total of 4 patients discontinued celecoxib due to upper gastrointestinal tract toxicity.
The team found that there was an overall response rate of 12% in the intent-to-treat population.
There were 2 partial responses and 2 patients with stable disease.
The team observed a significant decrease in serum CA 19.9 levels in 3 of 9 evaluable patients.
The median time to disease progression was 8 weeks, and the median overall survival was 15 weeks.
Dr Michele Milella and colleagues concluded, "The combination of oral celecoxib and 5-fluorouracil by protracted IV infusion was found to be feasible and well tolerated, and was capable of inducing durable objective responses, even in patients with far advanced, gemcitabine-resistant/refractory PDAC".
"Further exploration of COX-2 inhibitor/fluropyrimidine combinations is warranted".