¹Dipartimento di Biologia e Patologia Cellulare e Molecolare 'L. Califano', Istituto di Endocrinologia ed Oncologia Sperimentale 'G. Salvatore' del Consiglio Nazionale delle Ricerche, Facoltà di Medicina e Chirurgia, Università 'Federico II', via S. Pansini 5, Napoli 80131, Italy

Correspondence: Professor AM Acquaviva, E-mail: angacqua@unina.it

Received 16 September 2002; Revised 12 December 2002; Accepted 10 January 2003.

Abstract

In this review, we discuss the available experimental evidences supporting the chemopreventive efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on colorectal cancer and the biological basis for their possible role as anticancer agents. Although the comprehension of the mechanisms underlying the effects of these drugs on colon cancer cells is incomplete, research efforts in identifying the biochemical pathway by which NSAIDs exert their chemopreventive effect have provided a rationale for the potential use of NSAIDs alone or in combination with conventional and experimental anticancer agents in the treatment of colorectal cancer. In this paper, we review three main issues: (i) the role of COX-2 in colon cancer; (ii) the common death pathways between NSAIDs and anticancer drugs; and (iii) the biological basis for the combination therapy with COX-2 selective inhibitors and new selective inhibitors of growth factor signal transduction pathways.