Anti-Arthritis Drug May Help Prevent Cervical Cancer

Researchers at the UC are trying to determine if a drug commonly used to treat arthritis and acute pain can help prevent cervical cancer by stopping the disease in its precancerous stage.

Led locally by Nader Husseinzadeh, MD, a professor in the division of gynecological oncology at UC, this national phase 2 trial will test the effectiveness of celecoxib (Celebrex) in preventing cervical cancer. The trial is sponsored by the National Cancer Institute.

Celecoxib is a nonsteroidal drug used to reduce inflammation and is already approved by the Food and Drug Administration for the treatment of arthritis. It works by selectively blocking an enzyme known as cyclooxygenase-2 (COX-2), which is responsible for producing the chemical messengers that cause swelling and inflammation.

This is the first time that celecoxib has been studied in the treatment and prevention of cervical cancer.

Signs of cervical cancer first appear as cervical intraepithelial neoplasia (CIN), a precancerous condition in which abnormal cells appear on the surface of the cervix. This is often the result of a sexually transmitted infection.

By reducing inflammation and the associated infection, Dr. Husseinzadeh believes he may be able to stop the growth of abnormal cells and prevent the development of cervical cancer.

“No one knows the precise mechanism of the disease, but previous research suggests that if we can knock out the overproduction of COX-2, we can reduce—and possibly stop completely—the abnormal cell growth that leads to cervical cancer,” he says.

Previous studies have shown that the COX-2 enzyme is overproduced in colon, cervical and lung cancer. Research has also shown that drugs that inhibit COX-2 can stop tumor growth in mice.

National investigators will test the drug on about 100 women who are at the stage of CIN where cellular abnormality is about to transition to cancer.

Study participants will be randomized into one of two treatment groups.  The first group will receive celecoxib orally twice a day for 14 to 18 weeks. The second group will go through the same process, but with a placebo.

After eight weeks of treatment, participants will undergo a colposcopy exam, a technique that magnifies the surface tissue of the vulva, vagina and cervix to determine how they are responding to treatment.

If no disease is found during the colposcopy, the woman will have a cervical biopsy to ensure no abnormal cells remain. Patients who still have abnormalities in the final weeks of the trial will also undergo an electrosurgical procedure to remove the suspicious tissue.

“If celecoxib can stop the transformation from cellular abnormalities to cancer, it will help us prevent many cervical cancer cases and, ultimately, save lives,” says Dr. Husseinzadeh.

The American Cancer Society estimates that more than 10,370 women were diagnosed with cancer in 2005. The disease, most common in women over 40, will also result in about 3,700 deaths. Patients with invasive cervical cancer have a five-year survival rate of 92 percent.

Dr. Husseinzadeh is the principal investigator on more than 30 gynecological oncology clinical trials at UC. For more information on these trials, call Maria Smith at (513) 558-8146.