(Breast Cancer) Is Celecoxib Effective as Adjuvant Therapy?

On July 15, 2021, R. Charles Coombes and colleagues at Imperial College London published results in JAMA Oncology from The Randomized European Celecoxib Trial (REACT) Phase III clinical trial evaluating the COX-2 inhibitor celecoxib as adjuvant therapy in completely resected HER2-negative early breast cancer patients.

The REACT Phase III trial was a multicenter international study that randomized completely resected HER2-negative early breast cancer patients (N=2,639) in a 2:1 ratio to:

• Celecoxib group: Celecoxib 400 mg once daily for 2 years (N=1,763)
• Placebo group: For 2 years (N=876)

The primary endpoint was disease-free survival (DFS).

Of the 2,639 patients enrolled, the median age was 55.2 years (range: 26.8–86.0 years). 73% of patients were estrogen receptor-positive or progesterone receptor-positive and HER2-negative. Lymph node metastasis was positive in 48% (N=1,265).

Results:

At a median follow-up of 74.3 months, the primary endpoint of 5-year disease-free survival was: Celecoxib group 84% vs. placebo group 83% — no significant difference between groups. In terms of safety, the overall incidence of adverse events was low, with no significant differences between groups.

Based on the REACT trial results, R. Charles Coombes and colleagues concluded: In completely resected HER2-negative early breast cancer patients, the COX-2 inhibitor celecoxib as adjuvant therapy did not demonstrate a significant improvement in 5-year disease-free survival compared to placebo.

Source: https://jamanetwork.com/journals/jamaoncology/article-abstract/2781890

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Related Cancer Information

• Breast cancer