Novel endocrine therapies in breast cancer

Current directions for COX-2 inhibition in breast cancer

Chemotherapy is effective against breast cancer. COX-2 has been implicated in the progression and angiogenesis of cancers. Celecoxib, a cyclooxygenase type 2 (COX-2) inhibitor, has both apoptotic and antiangiogenic activities, and may be of use in treatment of breast tumors which overexpress the COX-2 enzyme. Preliminary clinical trials have shown that the combination of chemotherapy with celecoxib has minimal additional toxicity and it may enhance the effects of the chemotherapy. Beside chemotherapy, celecoxib may promulgate the effect of aromatase inhibitor in breast cancer cells. Animal studies have shown that there are fewer and smaller tumors treated by combining exemestane and celecoxib. Larger clinical trials should be initiated to study the potential anti-cancer effects of celecoxib in breast cancer.

Somatostatin and opioid receptors in mammary tissue. Role in cancer cell growth

Somatostatin and opioid systems, are the two main inhibitory systems in mammals. Both classes of substances have been identified in normal and malignant mammary gland, as well as their cognitive receptors. They have been implied in the inhibition of cell growth of cancer cells and cell lines, in a dose-dependent and reversible manner. Somatostatin acts through homologous receptors (SSTRs), belonging to five distinct classes (SSTR1-5). We, and others have identified SSTR2 and 3 as been the only SSTRs present in the breast. Furthermore, opioids act through the three classes of opioid receptors (mu, delta,kappa). In the breast, kappa opioid receptor subtypes (kappa 1-kappa 3) are the most widely expressed. We further have shown that opioids, in addition to their binding to opioid receptors, compete for binding to SSTRs. This functional interaction, together with other identified modes of opioid action in the breast (modulation of steroid receptors, proteases' secretion, interaction with cytoskeletal elements), will be discussed, taking into consideration also the possible local production of casomorphins (casein-derived opioids), which are very potent antiproliferative agents.