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Cancer chemoprevention. A review of ongoing clinical studies
A Costa1, G Santoro, G Assimakopoulos
1Istituto Nazionale Tumori, Milan, Italy.
Abstract:
The mass of experimental data on various possibilities of inhibiting the carcinogenic process is growing rapidly. However, the biological complexity of carcinogenesis and the intrinsic limitations of the animal models make it often very difficult to identify the real potentially effective agents among the hundreds currently being proposed. In fact, more than 600 potentially chemopreventive agents have been identified and approximately 30 of them are presently being tested in humans. The great heterogeneity of these compounds (they belong to over 20 different classes of chemicals) might be a positive feature as it indicates that a variety of approaches is possible and that the options for selecting effective compounds will be numerous. In recent years, what could be called 'clinical chemoprevention' (that is controlled studies to evaluate in human subjects the efficacy of potentially chemopreventive agents) has developed considerably: according to American estimates 4 chemopreventive agents were tested clinically in 1981, 10 in 1985 and 18 in 1988. The number of reported preclinical investigations was 10 in 1985 and 75 in 1988. This rapid expansion has obviously led to some confusion in terminology and in the evaluation of primary results; at present there is still a need for further investigations to better define clinical chemoprevention and to differentiate it from chemotherapy.
Insights
Identifying effective cancer prevention agents is challenging due to biological complexity and animal model limits. Clinical chemoprevention studies are expanding, but require clearer definitions to distinguish from chemotherapy.
Area of Science:
- Oncology
- Pharmacology
- Preventive Medicine
Background:
- Carcinogenesis is biologically complex, hindering identification of effective cancer prevention agents.
- Over 600 potential chemopreventive agents identified, with ~30 in human trials.
- Diverse chemical classes (20+) offer varied therapeutic approaches.
Purpose of the Study:
- To review the expanding field of clinical chemoprevention.
- To highlight the need for standardized terminology and evaluation methods.
- To differentiate clinical chemoprevention from chemotherapy.
Main Methods:
- Review of preclinical and clinical investigation data on chemopreventive agents.
- Analysis of trends in clinical chemoprevention studies (1981-1988).
Main Results:
- Significant growth in preclinical (75 in 1988) and clinical (18 in 1988) chemoprevention investigations.
- Rapid expansion has led to terminological confusion.
- Need for further research to define clinical chemoprevention.
Conclusions:
- Clinical chemoprevention is a rapidly developing field with diverse agents.
- Standardized definitions and evaluation are crucial for progress.
- Distinguishing chemoprevention from chemotherapy requires further investigation.