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Chemoprevention of colorectal cancer
M L Clapper1, W C Chang, N J Meropol
1Division of Population Science, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA. ml_clapper@fccc.edu
Abstract:
Chemopreventive strategies hold substantial promise for reducing the incidence of colorectal cancer, the second leading cause of cancer-related mortality in the United States. This review focuses on recent advances in the identification of molecular targets and novel strategies for chemopreventive intervention. Many clinical trials are now in progress to assess the ability of synthetic agents or nutritional supplements to alter either the number of colorectal adenomas or biomarkers associated with colorectal tumorigenesis. Populations under study include genetically defined high-risk people and those with increased risk based on a personal history of colorectal neoplasia. A recent study showing that celecoxib, a cyclooxygenase-2 inhibitor, can alter the natural history of polyp formation in patients with familial adenomatous polyposis has provided a benchmark for the clinical development of other chemopreventive agents and heightened awareness that colorectal cancer is a preventable disease.
Insights
Chemoprevention shows promise for reducing colorectal cancer incidence. Research is advancing molecular targets and novel strategies, with clinical trials assessing agents for high-risk individuals.
Area of Science:
- Oncology
- Gastroenterology
- Preventive Medicine
Background:
- Colorectal cancer is a leading cause of cancer mortality in the US.
- Chemoprevention offers a promising approach to reduce cancer incidence.
- Advances in molecular targets are crucial for effective intervention.
Purpose of the Study:
- To review recent advances in molecular targets for colorectal cancer chemoprevention.
- To discuss novel strategies and ongoing clinical trials for chemopreventive intervention.
- To highlight the potential of synthetic agents and nutritional supplements.
Main Methods:
- Review of current literature on colorectal cancer chemoprevention.
- Analysis of ongoing clinical trials assessing chemopreventive agents.
- Evaluation of biomarkers and adenoma formation as endpoints.
Main Results:
- Identification of key molecular targets for chemoprevention.
- Progress in clinical trials evaluating synthetic agents and supplements.
- Demonstration of celecoxib's efficacy in altering polyp formation.
Conclusions:
- Chemoprevention is a viable strategy for reducing colorectal cancer.
- Further research and clinical trials are essential for developing new agents.
- Awareness of colorectal cancer as a preventable disease is increasing.