Celecoxib (Celebrex) may ward off squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) in persons with extensive actinic damage who are at high risk for developing nonmelanoma skin cancers, according to the results of a recent multicenter trial. The drug, normally prescribed to relieve pain, tenderness, swelling, and stiffness caused by various arthritic conditions, has been shown in animals to inhibit the development of ultraviolet-induced premalignant skin papillomas. These papillomas are thought to correspond with actinic keratoses, the precursor of nonmelanoma skin cancers.
A total of 240 participants aged 37 to 87 years, with 10 to 40 actinic keratoses each, received 200 mg of oral celecoxib or placebo twice daily for 9 months. Although no difference in number of new actinic keratoses existed at the 9-month point, the investigators did note that at 11 months, the subjects in the celecoxib arm had fewer nonmelanoma skin cancers than those taking placebo: Mean cumulative tumor number per patient was 0.14 and 0.35, respectively. Relative risk for nonmelanoma skin cancers remained lower for the celecoxib users after adjusting for a number of factors.
“Celecoxib was not effective in preventing new actinic keratoses, but the study results raise the hypothesis that it may prevent some nonmelanoma skin cancers in patients who have actinic keratoses and thus are at high risk for the disease,” wrote Craig A. Elmets and fellow researchers in Journal of the National Cancer Institute (http://jnci.oxfordjournals.org/content/early/2010/11/29/jnci.djq442.full.pdf+html?sid=3f4d5c30-ac7b-48b8-95a9-515d5da3da9b).
COX-2 inhibitors have been reported to increase the risk of serious cardiovascular adverse events (myocardial infarction, stroke, heart failure, or cardiovascular [CV] deaths). However, CV adverse-event rates were similar in the two groups, with nine such events in seven patients who received celecoxib compared with six events in five placebo-takers.