Wells G, Chernoff J, Gilligan J P, Krause D S
University of Ottawa Heart Institute, Ottawa, Ontario, Canada, K1Y 4W7.
Fox Chase Cancer Institute, 333 Cottman Ave # 307, Philadelphia, USA.
Osteoporos Int. 2016 Jan;27(1):13-9. doi: 10.1007/s00198-015-3339-z. Epub 2015 Oct 5.
Recently an association between the use of calcitonin and cancer has been postulated. We reviewed the biological rationale and performed an additional analysis of historical data with respect to the possibility. An association cannot be excluded, but the relationship is weak and causality is unlikely. The purpose of the present study is to review the strength of association and likelihood of a causal relationship between use of calcitonin and cancer. We reviewed the evidence for this association, including the molecular signaling mechanisms of calcitonin, preclinical data, an "experiment of nature," and the results of a previous meta-analysis which showed a weak association. We performed an additional meta-analysis to incorporate the data from a novel investigational oral formulation of salmon calcitonin. Review of the literature did not identify a cellular signaling mechanism of action which might account for a causal relationship or toxicologic or postmarketing data to support the thesis. Additional clinical results incorporated into previous meta-analyses weakened but did not completely negate the possibility of association. A causal association between calcitonin use and malignancy is unlikely, as there is little biological plausibility. The preponderance of nonclinical and clinical evidence also does not favor a causal relationship.
最近有人提出降钙素的使用与癌症之间存在关联。我们审视了其生物学原理，并针对这种可能性对历史数据进行了补充分析。不能排除存在关联，但这种关系很弱，且因果关系不太可能成立。本研究的目的是审视降钙素的使用与癌症之间关联的强度以及因果关系的可能性。我们回顾了这一关联的证据，包括降钙素的分子信号传导机制、临床前数据、一项“自然实验”，以及之前一项显示关联较弱的荟萃分析结果。我们进行了一项补充荟萃分析，纳入了来自一种新型鲑鱼降钙素口服研究制剂的数据。文献回顾未发现可能解释因果关系的细胞信号传导作用机制，也没有毒理学或上市后数据支持这一论点。纳入之前荟萃分析的更多临床结果削弱了但并未完全排除关联的可能性。降钙素使用与恶性肿瘤之间的因果关联不太可能，因为几乎没有生物学合理性。非临床和临床证据的主体也不支持因果关系。
