# Chemopreventive Efficacy of Sulindac Sulfone as a Selective Apoptotic Antineoplastic Drug in Human Head and Neck Squamous Cell Carcinoma Cell Lines: A Systematic Review

## TL;DR

This paper reviews how sulindac sulfone, a drug metabolite, can prevent cancer growth in head and neck tumors by causing cell death and reducing cell proliferation.

## Contribution

The study systematically evaluates the chemopreventive efficacy and optimal dose of sulindac sulfone in head and neck squamous cell carcinoma.

## Key findings

- Sulindac sulfone shows anti-neoplastic effects in HNSCC cell lines at concentrations of 200-800 µM.
- The drug's efficacy is mediated through apoptosis and inhibition of cell proliferation.
- The results suggest sulindac sulfone can be safely used in HNSCC therapy.

## Abstract

Sulindac sulfone, an active metabolite of sulindac, a non-steroidal anti-inflammatory drug, has good anti-inflammatory potential. The antineoplastic effect of sulindac sulfone is mediated through a cyclooxygenase inhibitory mechanism, followed by apoptosis and inhibition of cell proliferation. Mounting studies have explored the anti-neoplastic effect of sulindac sulfone in various types of cancers in a dose-dependent manner. In this backdrop, we have conducted a systematic review to evaluate the efficacy and dose of sulindac sulfone as an anti-neoplastic agent in human head and neck squamous cell carcinoma cell lines (HNSCCs). In this study, we used a systematic literature review approach, and articles were searched in PubMed, and Medline with the keywords “sulindac sulfone,” “anti-neoplastic activity,” “chemopreventive,” and “head and neck squamous cell carcinoma”. A hand-search of journals was also performed. Articles were reviewed and analyzed. The analysis reveals that, based on the in vitro studies on various tumor models, the optimum concentration of sulindac sulfone which elicits anti-neoplastic effects is 200-800 µM. The anti-neoplastic effect is mediated through inhibition of cell proliferation and apoptosis. The results of our systematic review show that the anti-neoplastic activity of pharmacologic Sulindac sulfone is part of its dose-dependent activity, which can be safely employed in the therapy for human HNSCCs and would be responsible for a beneficial outcome of the treatment.