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黑色素瘤化学预防:现状与未来展望。

Melanoma Chemoprevention: Current Status and Future Prospects.

机构信息

Department of Dermatology, University of Wisconsin, Madison, WI.

William S. Middleton VA Medical Center, Madison, WI.

出版信息

Photochem Photobiol. 2017 Jul;93(4):975-989. doi: 10.1111/php.12749. Epub 2017 Apr 27.

Abstract

The incidence of skin cancers, both nonmelanoma and melanoma, is increasing in the United States. The ultraviolet radiation, mainly from sun, is considered the major cause for these neoplasms. While nonmelanoma skin cancers are far more numerous, melanoma remains the most challenging. This is because melanoma can become extremely aggressive and its incidence is increasing worldwide due to lack of effective early detection, as well as disease recurrence, following both surgery and chemotherapy. Therefore, in addition to better treatment options, newer means are required to prevent melanomas from developing. Chemoprevention is a reasonable cost-effective approach to prevent carcinogenesis by inhibiting the processes of tumor initiation, promotion and progression. Melanoma is a progressive disease, which makes it very suitable for chemopreventive interventions, by targeting the processes and molecular pathways involved in the progression of melanoma. This review discusses the roles of various chemopreventive agents such as NSAIDs, statins, vitamins and dietary agents in melanoma and highlights current advancements and our perspective on future of melanoma chemoprevention. Although considerable preclinical data suggest that melanoma may be prevented or delayed by a numerous chemopreventive agents, we realize there are insufficient clinical studies evaluating their efficacy and long-term safety for human use.

摘要

在美国,皮肤癌(包括非黑色素瘤和黑色素瘤)的发病率正在上升。紫外线辐射(主要来自太阳)被认为是这些肿瘤的主要原因。虽然非黑色素瘤皮肤癌的数量要多得多,但黑色素瘤仍然是最具挑战性的。这是因为黑色素瘤可能变得极具侵袭性,而且由于缺乏有效的早期检测以及手术和化疗后疾病的复发,其发病率在全球范围内正在上升。因此,除了更好的治疗选择外,还需要新的方法来预防黑色素瘤的发生。化学预防是一种合理的具有成本效益的方法,可以通过抑制肿瘤起始、促进和进展的过程来预防致癌作用。黑色素瘤是一种进行性疾病,这使其非常适合化学预防干预,通过针对黑色素瘤进展涉及的过程和分子途径。这篇综述讨论了各种化学预防剂(如 NSAIDs、他汀类药物、维生素和膳食剂)在黑色素瘤中的作用,并强调了目前的进展以及我们对黑色素瘤化学预防未来的看法。尽管大量的临床前数据表明,许多化学预防剂可能预防或延迟黑色素瘤的发生,但我们认识到,评估它们对人类使用的疗效和长期安全性的临床研究还不够充分。

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