Non-steroidal anti-inflammatory drugs and biomarkers: A new paradigm in colorectal cancer

Abstract

Colorectal cancer is a sporadic, hereditary, or familial based disease in its origin, caused due to diverse set of mutations in large intestinal epithelial cells. Colorectal cancer (CRC) is a common and deadly disease that accounts for the 4th worldwide highly variable malignancy. For the early detection of CRC, the most common predictive biomarker found endogenously are KRAS and ctDNA/cfDNA along with SEPT9 methylated DNA. Early detection and screening for CRC are necessary and multiple methods can be employed to screen and perform early diagnosis of CRC. Colonoscopy, an invasive method is most prevalent for diagnosing CRC or confirming the positive result as compared to other screening methods whereas several non-invasive techniques such as molecular analysis of breath, urine, blood, and stool can also be performed for early detection. Interestingly, widely used medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation have reported chemopreventive impact on gastrointestinal malignancies, especially CRC in several epidemiological and preclinical types of research. NSAID acts by inhibiting two cyclooxygenase enzymes, thereby preventing the synthesis of prostaglandins (PGs) and causing NSAID-induced apoptosis and growth inhibition in CRC cells. This review paper majorly focuses on the diversity of natural and synthetic biomarkers and various techniques for the early detection of CRC. An approach toward current advancement in CRC detection techniques and the role of NSAIDs in CRC chemoprevention has been explored systematically. Several prominent governing mechanisms of the anti-cancer effects of NSAIDs and their synergistic effect with statins for an effective chemopreventive measure have also been discussed in this review paper.

Genistein–Aspirin Combination Exerts Cytotoxic and Anti-Migratory Effects in Human Colorectal Cancer Cells

“…(iv) modulation of immune response; and (v) inhibition of proto-oncogenes, etc. [16][17][18]. Even though a significant body of evidence exists regarding the mechanisms involved in the anticancer effect of aspirin, this subject is far from fully elucidated.…”

The Multifaceted Effects of Non-Steroidal and Non-Opioid Anti-Inflammatory and Analgesic Drugs on Platelets: Current Knowledge, Limitations, and Future Perspectives

“…Nevertheless, not only classic antiplatelet drugs can serve as compounds for reducing platelet activation and aggregation. Since inflammation is tightly associated and triggered or is triggered by platelet activation, several compounds with anti-inflammatory potential have also been studied for potential antiplatelet effects [12]. They represent some of the world's most widely used prescription and over-the-counter medications, while some of them like ibuprofen and aspirin have been listed by the World Health Organization (WHO) in the list of essential medicines.…”

Synthesis and Preliminary Screening of the Biological Activity of Sulindac Sulfoximine Derivatives

“…Anti-inflammatory agents have been studied as adjuvants in cancer therapy during the past four decades [1,2]. This therapeutic strategy is well recognized, and its side effects are controlled.…”