Celecoxib Safe for Concurrent Use with Thoracic Radiotherapy in Non-Small Cell Lung Cancer

Strategic Insights -

Clinical trials led by researchers at the University of Texas, MD Anderson Cancer Center in Houston have shown that celecoxib, a selective cyclooxygenase-2 inhibitor, can be safely used concurrently with thoracic radiotherapy in patients with non-small cell lung cancer (NSCLC). The study aimed to determine whether celecoxib could be safely administered in approved doses when used with thoracic radiotherapy in patients with poor prognosis NSCLC. The trial consisted of three cohorts of patients, each receiving different doses of celecoxib, and the results showed that the main toxicities were grades 1 and 2 nausea and esophagitis, which were independent of the dose of celecoxib or radiotherapy schedule.

Key Takeaways:

  • Celecoxib can be safely administered concurrently with thoracic radiotherapy in patients with non-small cell lung cancer (NSCLC) at doses up to 800 mg/d.
  • The trial involved 47 patients, with 19 in cohort I, 22 in cohort II, and 6 in cohort III, and was designed to assess the safety of celecoxib in combination with thoracic radiotherapy.
  • The main toxicities observed were grades 1 and 2 nausea and esophagitis, which were independent of the dose of celecoxib or radiotherapy schedule.
  • Only two patients developed grade 3 pneumonitis, one on 200 mg and the other on 400 mg celecoxib.
  • Three patients experienced celecoxib-related toxicity, including uncontrolled hypertension and hemorrhagic episodes.
  • The actuarial local progression-free survival was 66.0% at 1 year and 42.2% at 2 years following initiation of radiotherapy.
  • The study's results showed that celecoxib can be safely used concurrently with thoracic radiotherapy, and further assessment in a phase II/III trial is warranted.

Statistics:

  • 47 patients were enrolled in the trial (19 in cohort I, 22 in cohort II, and 6 in cohort III).
  • The doses of celecoxib used were 200, 400, 600, and 800 mg/d.
  • 14 patients had complete response, 13 patients had partial responses, and 10 patients had stable or progressive disease.
  • 66.0% actuarial local progression-free survival at 1 year and 42.2% at 2 years following initiation of radiotherapy.

Sources:

  • Liao, Z.X., et al. "A phase I clinical trial of thoracic radiotherapy and concurrent celecoxib for patients with unfavorable performance status inoperable/unresectable non-small cell lung cancer." Clinical Cancer Research 11.9 (2005): 3342-3348.
  • Health & Medicine Week editors. "Celecoxib Safe for Concurrent Use with Thoracic Radiotherapy in Non-Small Cell Lung Cancer." Health & Medicine Week, 2005.