Cancer Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India.
Nutr Cancer. 2013;65 Suppl 1:12-25. doi: 10.1080/01635581.2013.785006.
Chemopreventive interventions are steadily emerging as an important aspect of cancer management and control. Herein, we have discussed the major epidemiological and clinical studies advocating the role of androgen inhibitors, flavonoids and antioxidants in preventing prostate cancer (PCa). Androgen inhibitors have lately been discussed not only in treatment of PCa, but also as preventive agents especially after trials with Finasteride and Dutasteride. Flavonoids such as silibinin, green tea polyphenols, genistein, curcumin have shown great promise, but avenues to improve their bioavailability are requisite. Agents with antioxidant potentials like lycopene, selenium, and vitamin E have also been explored. Antioxidant trials have yielded mixed results or benefitted only a subgroup of population, although further studies are needed to establish them as preventive agent. Although a majority of the trials resulted in positive outcomes supporting their role as preventive agents; one should be cautious of neutral or negative results as well. For clinical applicability of these agents, we need to identify the ideal target population, time of intervention, appropriate dosage, and extent of intervention required. Incoherency of data with these agents urges for a stringent study design and thorough interpretation to accurately judge the necessity and feasibility of the preventive measures.
化学预防干预措施作为癌症管理和控制的一个重要方面,正在稳步出现。在此,我们讨论了主要的流行病学和临床研究,这些研究主张雄激素抑制剂、类黄酮和抗氧化剂在预防前列腺癌(PCa)中的作用。雄激素抑制剂最近不仅在治疗 PCa 中被讨论,而且作为预防剂,特别是在 Finasteride 和 Dutasteride 的试验之后。类黄酮如水飞蓟素、绿茶多酚、染料木黄酮、姜黄素显示出巨大的希望,但需要提高它们的生物利用度的途径。具有抗氧化潜力的剂如番茄红素、硒和维生素 E 也已经被探索。抗氧化试验的结果喜忧参半,或者只使一部分人群受益,尽管需要进一步的研究来将它们确立为预防剂。尽管大多数试验的结果支持了它们作为预防剂的作用;但也应该谨慎对待中性或负面的结果。为了这些药物的临床应用,我们需要确定理想的目标人群、干预时间、适当的剂量和所需的干预程度。这些药物的数据不一致,需要严格的研究设计和彻底的解释,以准确判断预防措施的必要性和可行性。