New Prevention Weapon for Those at Risk for Colon Cancer
June 28, 2000 -- There's good news for people with a rare inherited colon
disease, reports TheNew England Journal of Medicine. The
disease, called familial adenomatous polyposis, causes polyps in the colon that
lead to cancer in nearly 100% of all cases. The report shows that the arthritis
drug Celebrex reduces these polyps by 30%.
And for those who the drug could benefit, no wait is required. Celebrex
received FDA approval for this use in December 1999. It was first approved for
arthritis about a year earlier.
Polyps are masses of tissue that bulge out from the walls of the intestines,
and since people with this disease begin to form these polyps at around 10
years of age, use of Celebrex may allow them to delay surgery until they are
through their teen years.
Right now, the only cure for the disease is removing the colon through
surgery. Without surgery, these patients will almost certainly go on to develop
colon cancer. Although polyps are often removed one by one, the sheer number of
polyps in this disease makes singular removal nearly impossible.
The study looked at nearly 80 patients with the disease and gave them the
study drug at either a 100-mg or 400-mg dose, or they received a placebo (dummy
pill). Those who received the 400-mg dose twice a day had the 30% reduction of
"We now have something we can feel reasonably good about using as an
agent that will delay surgery," Patrick M. Lynch, MD, tells WebMD. This
could enable these younger patients to undertake surgery when they are more
emotionally ready for its consequences. Lynch, one of the researchers, is an
associate professor of medicine in the department of gastrointestinal medical
oncology and digestive disease at MD Anderson Cancer Center in Houston. The
study also was conducted at St. Marks Hospital in London.
This 30% reduction of polyps also was seen with another arthritis drug,
Clinoril, Lynch says. Clinoril and other drugs in its class, nonsteroidal
anti-inflammatories, act similarly to Celebrex. However, they have some serious
side effects, such as bleeding in the stomach and intestines. Celebrex does not
appear to have these same side effects.
It is hoped, Lynch tells WebMD, that perhaps the number of polyps might be
diminished either through Celebrex alone or in a combination therapy, and then
surgery may help manage the disease without resorting to complete colon
However, removing the colon, Raymond N. DuBois, MD, PhD, tells WebMD, is
"still the gold standard and suggested therapy" for this disease.
DuBois is director of cancer prevention at the Vanderbilt-Ingram Cancer Center
in Nashville, Tenn.
The success of Celebrex at warding off colon cancer isn't surprising to
some. Gideon Steinbach, MD, another MD Anderson researcher, told WebMD in an
interview last year that drugs that are effective in familial adenomatous
polyposis could be very useful for preventing sporadic colon cancer.