Clinical and experimental studies on chemoprevention of colorectal cancer using piroxycam

Abstract

An experimental study was carried out by using mice with mutated Apc gene at codon 1309. After breeding the mice, Apc gene mutation was confirmed by the allele specific PCR method. Fourty mutated mice were randomly divided into two groups maintaining sexual balance in each group. One group was treated with piroxicam (P-group), and the other was the control group (C- group). The P-group was given piroxicam in tap water at a concentration of 0.05%. The estimated total dose administed to each mouse was l mg/kg. Mice were sacrificed at the 15th week, and polyps were counted by stereomicroscope. It was found that the number and size of polyps were much greater in the C-group than the P-group (number of polyps in gastrointestinal treact 30.81 vs 18.29). Then a clinical study was performed on three familial adenomatous polyposis (FA-P) patients who had undergone total colectomy with ileorectal anastomosis (IRA). The piroxycam suppositories, which contained 20 mg of piroxycam, were administered intrarectally once a day. Regression of adenomas was observed at 10 weeks. There were no complications or side effects of piroxycam. As a conclusion, piroxycam singnificantly decreased the occurence of polyps in the mouse model as well as the adenoma in the residual rectum of FAP patients. Postoperative intrarectal administration of piroxycam proved to be an effective chemopreventive agent for the rectal remnant by minimizing the side effects of oral NSAID.