Selective COX-2 inhibitor celecoxib has the potential to reduce acute toxicities of chemoradiation, in particular mucositis, in patients with head and neck cancer, according to a study presented at the European Society for Medical Oncology (ESMO) Asia 2016 Congress.

Researchers conducted a randomized, double blind, phase III clinical trial to examine the toxicity and efficacy of celecoxib administered concurrently with chemoradiation for locally advanced (stage III/IV) head and neck carcinoma.

A total of 122 patients were randomly assigned to receive celecoxib (100 mg qid; n=61) or placebo (n=61). The study drug was initiated on the first day of chemotherapy and was given for 8 weeks. Patients were treated with chemotherapy with cisplatin concurrently with radiation (60 to 70 Gy).

Researchers assessed acute toxicities every week by World Health Organisation scale.

In repeated measurement analysis of variance, a significant difference was noted in the time of onset of grade II acute toxicities between the celecoxib and placebo groups. There were significant changes in the mucositis, dysphagia, epidermitis and oral pain score over the typical 5 weeks in both groups, but these changes were more severe in the placebo group (p=0.0001).

In the analysis of overall changes in laboratory parameters, white blood cells, haemoglobin and platelet were reduced over time in both groups without any significant between-group differences.

Chemoradiotherapy-induced oral mucositis is a therapeutic challenge frequently encountered in cancer patients. This side effect causes significant morbidity and may delay or interrupt treatment. COX-2 inhibitors, such as celecoxib, have shown potential to lower these toxicities, according to researchers.