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Combined Neoadjuvant Chemotherapy and Celecoxib in Locally Advanced Breast Cancer

Author(s): N Ahmadloo | MA Nazer Mozaffari | M Mohammadianpanah | SH Omidvari | A Mosalaei | MA Mosleh Shirazi

Journal: Iranian Red Crescent Medical Journal
ISSN 1561-4395

Volume: 11;
Issue: 4;
Start page: 419;
Date: 2009;
Original page

Keywords: Neoadjuvant chemotherapy | Celecoxib | Locally advanced breast cancer | Cyclooxygenase-2 (COX- 2) inhibitor

Background: Locally advanced breast cancer is a presentation form of cancer with poor prognosis. The optimalmethod of treatment for these cases remains unclear. In this trial, the role of low dose celecoxib combined withneoadjuvant chemotherapy in locally advanced breast cancer was evaluated.Methods: Fifty women with pathologically proven locally advanced breast cancer were enrolled. All patientsreceived preoperative chemotherapy with CAF (Cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2, 5-FU 600mg/m2) regimen. They were randomly assigned into two groups. The first group received oral celecoxib (100 mgtwice daily) concurrently with chemotherapy and the second group was offered placebo. Chemotherapy wasadministered every three weeks and celecoxib continued until one week before the surgery. The patients receivedan average of 3 months treatment. The size of breast mass was measured before each cycle of chemotherapyby a caliper. The pathologic response rate was the primary endpoint of the study.Results: In this trial, 50 patients were eligible, of whom 44 were evaluable. There were 25 patients in the celecoxibgroup and 25 patients in the placebo arm. Two patients in each group developed metastasis during thetreatment course and two patients in group one could not tolerate celecoxib and quit it, so they were excludedfrom the trial. There was no statistically significant difference in terms of partial or complete response (90.5% vs.87.0%) between celecoxib and placebo groups. Histological type, grade and hormonal receptor were similar inthe two groups. No significant association was observed between menstrual status, size of mass at presentationand response to celecoxib.Conclusion: This study suggests that the use of celecoxib with a dose of 100 mg twice daily combined withneoadjuvant chemotherapy does not improve response rate in locally advanced breast cancer.
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