Celecoxib Window of Opportunity Trial to Assess Tumor and Stroma Responses

Advances in early detection techniques and improvement in systemic treatment of early stage
breast cancer have led to a small decline in overall breast cancer mortality in the last 20
years. New advances will require understanding of breast cancer biology at the molecular
level. Inhibition of COX-2 and its analysis of effect in breast cancer tumor microenvironment
provide one such fruitful therapeutic target. Tumor microenvironment is poorly understood in
breast cancer research. Despite new drugs being developed to treat breast cancer and tested
in clinical trials, it is rarely possible to assess how the drug is affecting the breast
cancer cells at a molecular level. The use of collagen properties such as alignment and
deposition will allow giving a faster diagnosis of breast cancer status and seeing how
celecoxib with respect to collagen can change the tumor microenvironment in human tissue.
This window trial provides a way to look at cancer and stromal cells before and after
celecoxib intake to see if the drug is actively working. If we can do this before and after a
patient has surgery, and see how the tumor microenvironment responds, then the physician
could pick a better suited adjuvant treatment for this patient after surgical intervention
that would improve their overall survival rate.

Inclusion Criteria:

- Participants must have biopsy proven invasive breast carcinoma stages T1cN0 to T3N0,
ER or PR positive with tumors greater than 1cm without lymph node spread.

- Participants must have a mammographic breast composition category (density) of c or d.

- Participants must be willing to participate and provide signed informed consent.

- Participants must have no immediate requirements for chemotherapy, radiotherapy or
hormonal therapy.

- Participants must be willing to discontinue any use of NSAIDs like aspirin or
ibuprofen until the tumor is removed

- Participants cannot be taking the following medications because of major
pharmacokinetic interactions with celecoxib while being enrolled in the study:
Abciximab, Argatroban, Bivalirudin, Cilostazol, Dabigatran, Etexilate, Dipyridamole,
Fondaparinux, Heparin, Lepirudin, Pemetrexed, Protein C, Rivaroxaban, Sibutramine,
Ticlopidine, Tirofiban, Vilazodone and Warfarin.

- Participants should pass MRI screening questionnaire

Exclusion Criteria:

- Prior history of cancer, neo-adjuvant chemotherapy and radiation therapy

- No daily NSAIDs intake within the past 4 weeks. Intermittent non-daily NSAIDs is
allowed under PI discretion.

- Current or prior systemic use of corticosteroids in the past month.

- Participants with history of hypertension, congestive heart failure, edema, stroke or
other cardiac disease or condition.

- Participants with type 2 diabetes, documented stomach ulcers and pulmonary embolism.

- Participants with aspirin or other NSAIDs-induced asthma or hypersensitivity reaction,
sulfonamide allergy

- Participants who are currently pregnant

- Participants with known human immunodeficiency virus (HIV) infection, hepatitis B
carrier state or with clinical evidence of hepatitis B.

- Participants who are not able to understand or provide written informed consent.

- Participants with standard contraindications to non-contrast MRI will be excluded,
including claustrophobia and metallic implants incompatible with MRI.

- Participants whose girth exceeds the bore of the MRI scanner.

- Participants requiring conscious sedation for MR imaging.