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Cancer chemoprevention
S M Lippman1, S E Benner, W K Hong
1Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Summary
Chemoprevention has advanced significantly, reversing premalignancy and preventing cancers. Future trials will determine the efficacy of agents like retinoids and tamoxifen.
Area of Science:
- Oncology
- Preventive Medicine
- Molecular Biology
Background:
- Chemoprevention is a rapidly evolving field focused on preventing cancer.
- Recent advances involve both clinical trials and basic science investigations.
Purpose of the Study:
- To review key recent developments in chemoprevention clinical trials and biologic studies.
- To highlight progress in understanding cancer development and prevention strategies.
Main Methods:
- Review of recent randomized clinical trials and molecular studies.
- Focus on definitive end points (cancer incidence) and potential intermediate end points (biomarkers).
- Analysis of phase III trial requirements, including subject numbers and trial duration.
Main Results:
- Significant success in reversing premalignancy in oral, skin, colon, and cervical tissues.
- Demonstrated efficacy in preventing primary skin and stomach cancers.
- Prevention of second primary tumors in head and neck and lung cancer patients.
- Advances in understanding molecular mechanisms, including the role of nuclear retinoic acid receptors.
Conclusions:
- Chemoprevention has matured, showing significant reversal or suppression of premalignancy.
- Ongoing phase III trials are critical for the future of chemoprevention.
- Key agents under investigation include retinoids, beta-carotene, alpha-tocopherol, tamoxifen, fenretinide, and finasteride.