Thursday, August 11, 2016

Sooo....advil works for SOME melanoma patients?????



I first reported on the supposed benefits of NSAID's ability to decrease cancer risk in 2012:  NSAID's and risk of skin cancer

Then last year (with much pandemonium in various news outlets this year) it was published that NSAID's reduced the bad boys - myeloid derived suppressor cells (MDSCs) and made anti-PD1 work better. 
Here's one post from 2015:  An Aspirin a day keeps melanoma at bay

Then at ASCO, they poured cold water over the whole thing.  See the last article in this post:  ASCO 2016: NSAID's many not aide response to anti-PD1 after all! 

But now, there's this: 

Differential expression of cyclooxygenase-2 in metastatic melanoma affects progression free survival.  Panza, De Cicco, Ercolano, et al.  Oncotarget. 2016 Aug 1.

The possible correlation between cyclooxygenase-2 (COX-2) expression and disease progression in melanoma is still a matter of debate. Analysis of COX-2 expression in 45 lymph node melanoma metastases demonstrates a significant correlation between the percent of expression and progression free survival (PFS). A positive COX-2 expression ≥10% (COX-2high), as opposite to a positive expression ≤9% (COX-2low), translated into a striking significant reduction of PFS of about 3 years. The reduction in PFS correlated neither with BRAFV600E nor with NRASQ61 expression in the analyzed samples. This concept was reinforced by the finding that tumour development in COX-2-/- mice was almost blunted. Similarly, inhibition of COX-2 protein expression in human melanoma cell lines, by using siRNAs technology as well as selective inhibition of COX-2 activity by celecoxib, reduced cellular proliferation and invasiveness. In conclusion we show that COX-2high is a negative prognostic factor in metastatic melanoma. Our study also clarifies that the uncertainty about the role of COX-2 in metastatic malignant melanoma, found in the current relevant literature, is probably due to the fact that a threshold in COX-2 expression has to be reached in order to impact on cancer malignancy. Our findings suggest that COX-2 expression may become an useful diagnostic tool in defining melanoma malignancy as well as argue for a possible therapeutic use of NSAID as add on therapy in selected cases.

For what it's worth!!! - c

2 comments:

  1. So, this study would suggest that patients in the US should take Celecoxib rather than aspirin or an NSAID?
    Sigh, being a geologist, I thought I would be able to decode these dang journal articles. Not so, I'm afraid. Wrong science department.

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  2. No....COX-2 inhibitors ARE all NSAIDs....you are not relegated to one "brand" or another. Additionally, this study was also looking at cyclooxygenase 2 expression of the tumor itself...as it influenced prognosis.

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