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Pharmacotherapy for inherited colorectal cancer

Patrick M Lynch1

  • 1The University of Texas MD Anderson Cancer Center, Department of Gastroenterology, Hepatology & Nutrition, 1515 Holcombe Blvd., Unit 1466, Houston, Texas, USA. plynch@mdanderson.org

Expert Opinion on Pharmacotherapy
|March 30, 2010
PubMed
Abstract

Insights

Chemoprevention clinical trials in familial adenomatous polyposis (FAP) have established a basis for using drugs like sulindac and celecoxib. These trials also provide a foundation for studying chemoprevention in non-familial adenomas.

Area of Science:

  • Gastroenterology and Oncology
  • Clinical Pharmacology

Background:

  • Primary prevention, or chemoprevention, of adenomas is a key consideration in managing colorectal cancer risk.
  • Familial adenomatous polyposis (FAP) serves as a crucial model for studying chemoprevention strategies.
  • Numerous agents and combinations have demonstrated potential in clinical trials.

Purpose of the Study:

  • To review the current state of chemoprevention in familial adenomatous polyposis (FAP) from a clinical perspective.
  • To highlight the role of FAP chemoprevention trials in guiding clinical drug use.
  • To establish how FAP trials can inform future research in non-familial adenomas.

Main Methods:

  • Focus on randomized clinical chemoprevention trials.
  • Systematic literature search of PubMed from 1980 to present.

Main Results:

  • Established the clinical utility of sulindac and celecoxib as adjuncts in FAP management.
  • Demonstrated the value of FAP trials in providing a foundation for broader chemoprevention research.
  • Highlighted the role of short-term drug administration (3-12 months) in assessing adenoma regression.

Conclusions:

  • FAP trials are essential for evaluating new chemopreventive agents.
  • Adenoma regression in retained rectal segments is a key endpoint.
  • Findings from FAP studies can be extrapolated to non-familial adenoma chemoprevention.

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