Chemopreventive Agent Development Research Group, Division of Cancer Prevention, NIH, Bethesda, Maryland, USA.
Cancer Prev Res (Phila). 2009 Nov;2(11):951-6. doi: 10.1158/1940-6207.CAPR-09-0080.
Nonsteroidal anti-inflammatory drugs (NSAID) have been highly effective in preventing colon, urinary bladder, and skin cancer preclinically, and also in clinical trials of colon adenoma formation. However, certain NSAIDs cause gastrointestinal ulceration and may increase cardiovascular events. Naproxen seems to cause the lowest cardiovascular events of the common NSAIDs other than aspirin. Nitric oxide (NO)-naproxen was tested based on the finding that adding a NO group to NSAIDs may help alleviate GI toxicity. In the azoxymethane-induced rat colon aberrant crypt foci (ACF) model, naproxen administered at 200 and 400 ppm in the diet reduced mean ACFs in the colon by about 45% to 60%, respectively. NO-naproxen was likewise administered in the diet at roughly equimolar doses (300 and 600 ppm) and reduced total ACF by 20% to 40%, respectively. In the hydroxybutyl (butyl) nitrosamine rat urinary bladder cancer model, NO-naproxen was given at 183 or 550 ppm in the diet, and naproxen at 128 ppm. The NO-naproxen groups had 77% and 73% decreases, respectively, in the development of large urinary bladder tumors, whereas the 128 ppm naproxen group also showed a strong decrease (69%). If treatments were started 3 months after hydroxybutyl (butyl) nitrosamine, NO-naproxen (550 ppm) and naproxen (400 ppm) were also highly effective (86-94% decreases). In the methylnitrosourea-induced mammary cancer model in rats, NO-naproxen and naproxen showed nonsignificant inhibitions (12% and 24%) at 550 and 400 ppm, respectively. These data show that both naproxen and NO-naproxen are effective agents against urinary bladder and colon, but not mammary, carcinogenesis.
非甾体抗炎药(NSAID)在预防结肠癌、膀胱癌和皮肤癌的临床前研究中非常有效,也在结肠癌腺瘤形成的临床试验中得到了验证。然而,某些 NSAID 会导致胃肠道溃疡,并可能增加心血管事件的发生。与阿司匹林以外的常见 NSAID 相比,萘普生似乎引起的心血管事件最低。一氧化氮(NO)-萘普生是基于添加 NO 基团到 NSAID 可能有助于减轻胃肠道毒性的发现而进行测试的。在氧化偶氮甲烷诱导的大鼠结肠异常隐窝病灶(ACF)模型中,饮食中分别给予 200 和 400 ppm 的萘普生可使结肠中平均 ACF 分别减少约 45%至 60%。NO-萘普生也以大致等摩尔剂量(300 和 600 ppm)给予饮食,并分别使总 ACF 减少 20%至 40%。在羟丁基(丁基)亚硝胺诱导的大鼠膀胱癌模型中,NO-萘普生在饮食中以 183 或 550 ppm 给予,萘普生以 128 ppm 给予。NO-萘普生组中,大膀胱癌的发展分别减少了 77%和 73%,而 128 ppm 萘普生组也显示出强烈的减少(69%)。如果在羟丁基(丁基)亚硝胺后 3 个月开始治疗,NO-萘普生(550 ppm)和萘普生(400 ppm)也非常有效(减少 86-94%)。在大鼠甲基亚硝脲诱导的乳腺癌模型中,NO-萘普生和萘普生分别在 550 和 400 ppm 时显示出无显著抑制作用(12%和 24%)。这些数据表明,萘普生和 NO-萘普生均是预防膀胱癌和结肠癌的有效药物,但对乳腺癌的发生没有抑制作用。