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Advancing Gastric Cancer Chemoprevention: Early Signals and Ongoing Challenges
1Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York.
Cancer Prevention Research (Philadelphia, Pa.)
|July 1, 2026
Summary
Chemoprevention for gastric cancer shows promise with curcuminoids and eflornithine in high-risk patients. Further research is needed to validate long-term efficacy and safety for durable cancer prevention.
Area of Science:
- Oncology
- Gastroenterology
- Preventive Medicine
Background:
- Gastric cancer chemoprevention is underdeveloped despite significant disease burden.
- A defined premalignant window offers a therapeutic target for intervention.
Purpose of the Study:
- To evaluate the feasibility and preliminary efficacy of curcuminoids and eflornithine for gastric cancer chemoprevention.
- To assess safety and tolerability of these agents in patients with premalignant gastric conditions.
Main Methods:
- Two Phase IIa clinical trials were conducted in Puerto Rico and Honduras.
- Participants had diagnosed gastric premalignant conditions.
- Biomarkers including IL1β, pH2AX, and DNA damage were assessed.
Main Results:
- Curcuminoids demonstrated a reduction in the inflammatory marker IL1β.
- Eflornithine suggested a delayed reduction in DNA damage (pH2AX).
- Both agents were generally well tolerated; eflornithine was associated with hearing-related adverse events.
Conclusions:
- Mechanism-based chemoprevention for gastric cancer is feasible.
- Challenges include patient selection, surrogate endpoint validation, and long-term safety.
- Demonstrating durable cancer prevention beyond short-term biomarker changes is critical.
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