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COX-2 is commonly overexpressed in canine and feline small intestinal epithelial tumors and therefore the use of nonsteroidal antiinflammatory agents may represent a rational treatment approach in the primary setting with nonresectable disease or alternatively in an adjuvant setting.90, 91 To date, the only nonsteroidal antiinflammatory drug (NSAID) with a documented in vivo antitumor effect is piroxicam.92, 93 I believe that from an evidence-based medicine perspective the lead NSAID for antitumor use should continue to be piroxicam until further in vivo studies with NSAIDs of improved safety profile become available