Emerging Prognostic Biomarkers in Non Small Cell Lung Cancer Patients:Impact of Treatment with Nimesulide (COX-2 Inhibitor) Combined with Chemotherapy

Abstract

To date, the treatment outcome of non small cell lung cancer (NSCLC) is still not satisfactory and new treatment options are urgently needed. The present study was designed to: 1) evaluate the effects of the antiangiogenic drug; nimesulide (NSAID, a COX-2 inhibitor) combined with chemotherapy on NSCLC treatment progress, 2) Evaluate the role of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), as prognostic indicators in NSCLC, 3) Correlate the above parameters levels with the clinicopathological status of the patients during the therapy. The study included 30 NSCLC. The patients were divided to: group I, included 17 patients received chemotherapy alone and group II included 13 patients received the same chemotherapy with Nimesulide and 10 as controls. Serum and biopsies were taken for all subjects on admission and 3 weeks after the completion of treatment. Results: serum and tissue levels of VEGF and bFGF, were significantly higher in NSCLC patients and decreased significantly after treatment specially in group II compared to group I. The serum and tissue levels of the studied parameters decreased significantly in the responders as compared to resistant cases. The response rate after combined therapy was 69% versus 53% after chemotherapy alone. In conclusion, Nimesulide appears to boost the efficacy of the traditional chemotherapy as its co-administration showed encouraging effects on improving and normalization of the proangiogenic parameters levels and in turn the vascular supply of tumors. This may have good impact on the patient outcome, prolongation of their survival rate and prognosis.