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Among them, celecoxib (a 1,5-diarylpyrazole compound), the first COX-2-specific inhibitor used to inhibit tumor apoptosis, proliferation, angiogenesis, and metastasis (Wei et al., 2004), has been shown to suppress CIH-induced malignant transformation of tumors and reverse the abnormal regulation of host immune responses by CIH in mice with OSA-associated lung cancer ( Despite the potential adjuvant therapeutic value of COX inhibitors, key research gaps remain: subtype-specific clinical studies are needed to clarify their differential effects on proliferation and metastasis of lung cancer with different driver gene mutations, while balancing their vascular regulatory effects with risks such as gastrointestinal side effects and altered CBF