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Ann Thorac Surg 2003;76:1327-1335
© 2003 The Society of Thoracic Surgeons

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Review

Lung cancer and cyclooxygenase-2

^a Department of Preventive Medicine, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
^b Department of Pediatrics, Los Angeles, CA, USA
^c Department of Cell and Neurobiology, Los Angeles, CA, USA
^d Department of Cardiothoracic Surgery, Hastings Thoracic Oncology Laboratory, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA

^* Address reprint requests to Dr Bremner, Department of Cardiothoracic Surgery, Keck School of Medicine of the University of Southern California, 1510 San Pablo St, Suite 415, Los Angeles, CA 90033, USA
e-mail: rbremner{at}surgery.usc.edu

Lung cancer is by far the leading cause of cancer-related death. Overall survival is poor and has not improved substantially over the last half century. It is clear that new approaches are needed and these should include prevention, screening for early detection, and novel treatments based on our understanding of the molecular biology of this disease. Recently attention has been drawn to the role of the cyclooxygenase (COX) enzyme and its involvement in tumorigenesis. Investigations have documented two isoforms, COX-1 and COX-2, encoded by different genes. COX-1 is constitutively expressed in most tissues and appears to be responsible for the production of prostaglandins mediating normal physiologic functions, such as the maintenance of gastric mucosa and regulation of renal blood flow. In contrast, COX-2 is normally undetectable in most tissues, and is induced by cytokines, growth factors, oncogenes, and tumor promoters. A growing body of evidence indicates COX-2 plays a key role in lung cancer, and can serve as a potential marker of prognosis in this disease. Furthermore, the recent availability of COX-2 inhibitor medications offers a unique opportunity to interfere with the development of lung cancer and the progression of metastasis. Because COX-2 inhibitors have been demonstrated to interfere with tumorigenesis, the COX-2 enzyme may be an attractive target for therapeutic and chemoprotective strategies in lung cancer patients.

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