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Background: Several preclinical and clinical studies have demonstrated that cyclooxygenase-2 (Cox-2) inhibitors have anti-tumor activity in the treatment of non-small-cell lung cancer. However, there is little data on the use of Cox2 inhibitors in patients with small cell carcinoma (SCLC). The aim of this prospective study was to evaluate the role of Rofecoxib , a selective Cox2 inhibitor in combination with conventional chemotherapy in SCLC treatment. Methods: Patients with extensive small-cell lung cancer and median age 62±11.7 years, were randomized to receive oral rofecoxib 12.5 mg twice daily every day plus cisplatin 25 mg/m(2) and etoposide 100 mg/m2 or chemotherapy alone. Both regimens were repeated every 4 weeks until disease progression. Primary end points of our study were survival and time to progression Results: 98 patients were enrolled. 44 pts were randomly assigned chemotherapy plus rofecoxib and 54 chemotherapy alone. Median OS was 14 months (95% CI, 11.5 to 16 mo) for the cox-2 arm and 7.7 months (95% CI, 6 to 9.4) for chemotherapy(control) arm, which is statistically significant (p= 0.001). Median time to progression was 9.2 months (95% CI, 7.4 to 11) for the cox-2 arm and 5 months (95% CI, 3.7 to 6.5) for the control arm (p= 0.004). The response rates were 48.0 and 29.6%, respectively. Toxicity was mild, and no increase in cardiovascular events was observed. Conclusion: In advanced SCLC, rofecoxib in combination with chemotherapy improves survival , but the results must be interpreted with caution due to the limited number of patients.

Aims and Objectives: The aim of this study was to evaluate the comorbidity of diadetes mellitus(D.M) and to examine the survival difference between the patients with NSCLC, with history of D.M. and those without. Methods: 1222 patients first diagnosed with NSCLC, with non-operable stage IIIa, IIIb and IV, received 1st line platinum based chemotherapy (CHT) for up to six cycles. 321/1222 patients suffered from D.M. 301/1222 who presented progression of disease they submitted in 2nd line by which 69/301 were diabetic. 74 who progressed after the completion of 2nd line CHT were treated with 3nd line CHT by which 19/74 had history of D.M. Results: The patients without D.M. had longer time to progression (TTP), than those without, statistically important (p