Research progress on COX-2/PGE₂/EP₄ signaling axis in colon cancer

The expression of cyclooxygenase 2 (COX-2) was up-regulated and prostaglandin E2 (PGE2) was significantly increased in colon cancer patients. As the main prostaglandin produced by COX-2, PGE2 plays an important role in angiogenesis, survival, invasion and migration of colon cancer cells. The EP4 receptor, as an important transporter of PGE2 signaling, increases the survival and development of colon cancer cells through various mechanisms of overexpression. Signal pathway starting from COX-2, continuing with PGE2 and ending with EP4 can promote the spread and growth of colon cancer. Therefore, targeting the COX-2/PGE2/EP4 axis may be a valuable treatment method for colon cancer. This article outlines the biological activity of COX-2, the mechanism of action of COX-2/PGE2/EP4 as a signal axis in colon cancer, and the research progress of targeted drugs in colon cancer prevention.