Kelloff Gary J, Higley Howard R, Brawer Michael K, Lucia M Scott, Sigman Caroline C, Crawford E David
Rev Urol. 2002 Spring;4(2):69-77.
Chemoprevention is the administration of agents (drugs, biologics, and nutrients) to prevent induction, inhibit, or delay the progression of cancers. Prostate cancer is an important target for chemoprevention because of its long latency and high prevalence. The development of rational chemopreventive strategies requires knowledge of the mechanisms of prostate carcinogenesis and identification of agents that interfere with these mechanisms. Because of the long time period for prostate carcinogenesis and the large size of the cohort required for an evaluable study, identification and characterization of early intermediate biomarkers and their validation as surrogate endpoints for cancer incidence are essential for chemopreventive agent development. Finally, suitable populations with appropriate risk factors, including the presence of premalignant lesions and genetic predispositions, need to be well characterized for future chemopreventive interventions.
化学预防是指使用药物(化学合成药物、生物制剂和营养物质)来预防癌症的诱发、抑制或延缓癌症进展。前列腺癌因其潜伏期长且发病率高,是化学预防的重要靶点。制定合理的化学预防策略需要了解前列腺癌发生的机制,并识别能够干扰这些机制的药物。由于前列腺癌发生的时间较长,且可评估研究所需的队列规模较大,因此识别和表征早期中间生物标志物,并将其验证为癌症发病率的替代终点,对于化学预防药物的开发至关重要。最后,需要对具有适当风险因素(包括癌前病变和遗传易感性)的合适人群进行充分表征,以便未来进行化学预防干预。