Biomarkers and predictors of the chemopreventative capacity of non-steroidal anti-inflammatory drugs (NSAIDs)

Inflammation has been found to be an important part of the carcinogenic process. As such, potential use of non-steroidal anti-inflammatory drugs (NSAIDs) to lower inflammation and mitigate the risk of carcinogenesis has been investigated. Genetic variations and short nucleotide variants (SNVs) may contribute to differences in the efficacy of NSAIDs in cancer prevention. The purpose of this literature review is to present evidence regarding biomarkers significantly associated with the chem-opreventative capacity of regular NSAID use. A literature search was conducted in Medline and Embase databases utilizing the keywords “cancer,” “inflammation” and “biomarkers.” Articles that reported on genetic or protein biomarkers associated with cancer prevention, cancer recurrence, and/or the clinical efficacy and toxicity of NSAIDs for cancer treatment were considered eligible. Eight articles were included in this review and 33 genetic predictors were found to be associated with the prophylactic efficacy and toxicity of NSAID use in cancer. The current literature related to colorectal, lung, and prostate cancers has failed to consistently support the ability of NSAIDs to reduce cancer risk; however, a negative association between breast cancer and the use of COX-2 (also known as PTGS2) inhibitors has been suggested. The inconsistent nature of the current state of research demands further study and exploration into the pharmacogenetics of NSAIDs.