Celecoxib is a Cox-2 selective nonsteroidal anti-inflammatory medication (commonly sold as Celebrex) that is most frequently used for relief of pain and inflammation. Several trials have investigated the potential for celecoxib, in combination with ADT, to delay prostate cancer progression to androgen independence; i.e., the state where the cancer cells become resistant to ADT and can grow without testosterone. Although preliminary studies suggest that adding celecoxib may delay this progression, results have been mixed, and more research is needed.
A large, retrospective, observational study was conducted to further investigate the impacts of celecoxib combined with ADT on the overall survival, skeletal related events, and death from prostate cancer in men with advanced prostate cancer. Use of celecoxib was defined as taking the medication for at least 180 days.
Researchers used data from the Veterans Affairs (VA) Corporate Data Warehouse to analyze health, demographic, and medication information from 87,344 prostate cancer patients. The study sample was divided into two groups: 1) 1,581 men with prostate cancer, who were on ADT and celecoxib; 2) 85,763 men with prostate cancer, who were on ADT but not taking celecoxib.
1. Interestingly, the group of men who were on ADT and celecoxib had lower PSA levels at diagnosis and at initiation of ADT, when compared to men who were not taking celecoxib. The mechanisms accounting for this are not clear, but the researchers hypothesize that celecoxib may contribute to a lowering of PSA levels through an inducible enzyme or via its effect on some inflammatory processes.
2. Results of statistical analyses demonstrate no significant difference in Gleason score, death from prostate cancer, or number of skeletal related events between the two groups. Overall, celecoxib was also not associated with improved overall survival, risk of skeletal related events, or improved prostate cancer-specific death.
Results of this study, involving data from over 87,000 prostate cancer patients, suggest that use of celecoxib in combination with ADT may not lead to any meaningful impacts on survival outcomes. However, as the researchers note, more studies are needed and warranted, particularly of prospective design.
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Etheridge, T., Liou, J., Downs, T. M., Abel, E. J., Richards, K. A., & Jarrard, D. F. (2018). The impact of celecoxib on outcomes in advanced prostate cancer patients undergoing androgen deprivation therapy. American Journal of Clinical and Experimental Urology, 6(3), 123-132. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055075/