Dovizio Melania, Sacco Angela, Patrignani Paola
Section of Cardiovascular and Pharmacological Sciences, Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University, Chieti, Italy; CeSI-MeT (Centro Scienze dell'Invecchiamento e Medicina Traslazionale), "G. d'Annunzio" University, Chieti, Italy.
Section of Cardiovascular and Pharmacological Sciences, Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University, Chieti, Italy; CeSI-MeT (Centro Scienze dell'Invecchiamento e Medicina Traslazionale), "G. d'Annunzio" University, Chieti, Italy.
Vascul Pharmacol. 2017 Feb;89:1-11. doi: 10.1016/j.vph.2017.01.003. Epub 2017 Jan 12.
The prevention of cancer development and its progression is an urgent unmet medical need. Novel knowledge on the biology of cancer has evidenced that genetic changes occurring within cancer cells contribute, but are not sufficient, for tumor promotion and progression. The results of clinical studies and experimental animal models have suggested pursuing new avenues for the prevention of cancer development in the early stages, by using drugs that modulate platelet responses and those interfering with the synthesis and action of the mediators of inflammation. In fact, malignant tumors often develop at sites of chronic injury associated with platelet activation and chronic inflammation. In this review, we cover the evidence supporting this hypothesis and the rationale for the pharmacological treatment with antiplatelet agents, including low-dose aspirin, and antiinflammatory drugs to curb tumorigenesis and malignant progression. The evidence for a chemopreventive effect of low-dose aspirin against colorectal cancer (CRC) has been recently found appropriate by the U.S. Preventive Services Task Force, which recommends the use of the drug for primary prevention of cardiovascular disease and CRC.
预防癌症发生及其进展是一项亟待满足的紧迫医学需求。关于癌症生物学的新知识表明,癌细胞内发生的基因变化虽对肿瘤的促进和进展有作用,但并不充分。临床研究和实验动物模型的结果提示,通过使用调节血小板反应的药物以及干扰炎症介质合成与作用的药物,探索早期预防癌症发生的新途径。事实上,恶性肿瘤常发生于与血小板活化和慢性炎症相关的慢性损伤部位。在本综述中,我们阐述了支持这一假说的证据以及使用抗血小板药物(包括低剂量阿司匹林)和抗炎药物进行药物治疗以抑制肿瘤发生和恶性进展的基本原理。美国预防服务工作组最近认为,低剂量阿司匹林对结直肠癌(CRC)具有化学预防作用的证据是充分的,该工作组建议使用该药用于心血管疾病和CRC的一级预防。