Celecoxib

Celecoxib is a selective COX-2 inhibitor that Pfizer (then Searle and Pharmacia) launched for arthritis pain; the FDA approved it in 1998. It had an accelerated approval in 1999 for reducing polyps in familial adenomatous polyposis, which Pfizer withdrew in 2011 after the confirmatory study was not completed.

Its oncology use today is as part of low-cost oral metronomic chemotherapy. At Tata Memorial Hospital, Patil and colleagues randomised patients with recurrent or metastatic head and neck cancer who could not afford or tolerate standard drugs to oral methotrexate 15 mg/m2 weekly with celecoxib 200 mg twice daily or to intravenous cisplatin every three weeks; the oral pair gave longer survival with fewer serious side effects, and adding one-twentieth of the usual dose of nivolumab improved survival further in a later trial. The regimen is named on the oral cavity, tongue, buccal mucosa and recurrent or metastatic head and neck cancer pages as the option where resources are limited.