Wolff Robert A
The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Int J Gastrointest Cancer. 2003;33(1):27-41. doi: 10.1385/IJGC:33:1:27.
For a number of solid tumors, including pancreatic cancer, efforts aimed at disease prevention may be more successful than currently available anticancer treatments. While specific interventions are emerging to prevent breast, prostate, lung, and colorectal cancer, no trials of chemoprevention are being conducted in pancreatic cancer. Importantly, there are significant obstacles to the conduct of such research. However, preclinical and epidemiologic studies suggest that several drugs may have chemopreventive potential in pancreatic cancer. These include aspirin and other non-steroidal antiinflammatory drugs (NSAIDs), selective cyclooxygenase inhibitors, somatostatin analogs, selective estrogen receptor modulators (SERMs), and anti-androgenic agents. As the oncology community evaluates some of these agents in large chemoprevention trials for breast, colon, and prostate cancer, it may be found that pancreatic cancer prevention occurs as an unintended, but desirable consequence. Moreover, other general societal trends, such as smoking cessation and the widespread use of cholesterol-lowering agents and aspirin, could have a role in reducing the risk of pancreatic cancer, and in the future, may lead to a decrease in its incidence.
对于包括胰腺癌在内的多种实体瘤，旨在预防疾病的努力可能比目前可用的抗癌治疗更为成功。虽然针对乳腺癌、前列腺癌、肺癌和结直肠癌的特定预防措施正在出现，但尚未开展胰腺癌化学预防的试验。重要的是，开展此类研究存在重大障碍。然而，临床前和流行病学研究表明，几种药物可能在胰腺癌中具有化学预防潜力。这些药物包括阿司匹林和其他非甾体抗炎药（NSAIDs）、选择性环氧化酶抑制剂、生长抑素类似物、选择性雌激素受体调节剂（SERM）和抗雄激素药物。随着肿瘤学界在乳腺癌、结肠癌和前列腺癌的大型化学预防试验中评估其中一些药物，可能会发现胰腺癌预防作为一种意外但理想的结果而出现。此外，其他一般社会趋势，如戒烟以及降胆固醇药物和阿司匹林的广泛使用，可能在降低胰腺癌风险方面发挥作用，并且在未来可能导致其发病率下降。
