Veronesi Umberto, Bonanni Bernardo
European Institute of Oncology, Via G. Ripamonti, 435, 20141 Milan, Italy.
Eur J Cancer. 2005 Sep;41(13):1833-41. doi: 10.1016/j.ejca.2005.06.007.
Chemoprevention is by now an emerging area of clinical oncology addressed to healthy individuals at higher risk for cancer, subjects with precancerous conditions, and patients who are at risk for a second primary cancer. The important results of large trials with various agents and the more accurate methods of risk assessment have already had implications in clinical practice. Recently, a number of compounds have shown to be clinically effective at various organ levels, often covering all the three settings of primary, secondary and tertiary prevention. There is proof today that at least 3 of the 4 'big killers' in oncology--breast, colon and prostate cancer--and oral cancer are to a certain extent preventable by chemopreventive drugs. The missing piece so far is lung cancer. The expanding molecular drug development is providing the tools for a more effective and safer molecular-targeted prevention. Combination chemoprevention and the use of agents with multiple effects are other particularly promising chemoprevention strategies.
化学预防如今已成为临床肿瘤学中一个新兴领域，针对癌症高危健康个体、癌前病变患者以及有患第二原发性癌症风险的患者。使用各种药物进行的大型试验所取得的重要成果以及更精确的风险评估方法已对临床实践产生影响。最近，许多化合物已证明在各个器官层面具有临床疗效，常常涵盖一级、二级和三级预防的所有三种情况。如今有证据表明，肿瘤学中的4种“主要杀手”——乳腺癌、结肠癌、前列腺癌和口腔癌——至少有3种在一定程度上可通过化学预防药物预防。到目前为止，缺失的一块是肺癌。不断扩展的分子药物研发正在提供工具，以实现更有效、更安全的分子靶向预防。联合化学预防以及使用具有多种作用的药物是其他特别有前景的化学预防策略。
