Cyclooxygenase Inhibition in Cancer — A Blind Alley or a New Therapeutic Reality?

In their prevention trial, published in this issue of the Journal, Giardiello et al. showed that the nonsteroidal antiinflammatory drug (NSAID) sulindac did not inhibit the development of colorectal adenomatous polyps in subjects with genotypically proven familial adenomatous polyposis who had an endoscopically normal colon at the commencement of treatment.1 Why did this approach fail, and what are the lessons for the prevention and treatment of sporadic colorectal cancer and other cancers?The prevalence of familial adenomatous polyposis is about 1 in 8000. It is an autosomal dominant condition in which at least 100 and up to thousands of adenomatous . . .