Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; email:
Annu Rev Pharmacol Toxicol. 2023 Jan 20;63:165-186. doi: 10.1146/annurev-pharmtox-052020-023107. Epub 2022 Oct 6.
Chemoprevention refers to the use of natural or synthetic agents to reverse, suppress, or prevent the progression or recurrence of cancer. A large body of preclinical and clinical data suggest the ability of aspirin to prevent precursor lesions and cancers, but much of the clinical data are inferential and based on descriptive epidemiology, case control, and cohort studies or studies designed to answer other questions (e.g., cardiovascular mortality). Multiple pharmacological, clinical, and epidemiologic studies suggest that aspirin can prevent certain cancers but may also cause other effects depending on the tissue or disease and organ site in question. The best-known biological targets of aspirin are cyclooxygenases, which drive a wide variety of functions, including hemostasis, inflammation, and immune modulation. Newly recognized molecular and cellular interactions suggest additional modifiable functional targets, and the existence of consensus molecular cancer subtypes suggests that aspirin may have differential effects based on tumor heterogeneity. This review focuses on new pharmacological developments and innovations in biopharmacology that clarify the potential role of aspirin in cancer chemoprevention.
化学预防是指使用天然或合成制剂来逆转、抑制或预防癌症的进展或复发。大量的临床前和临床数据表明阿司匹林具有预防前体病变和癌症的能力，但其中许多临床数据是推论性的，基于描述性流行病学、病例对照和队列研究，或者是为回答其他问题而设计的研究（例如心血管死亡率）。多项药理学、临床和流行病学研究表明，阿司匹林可以预防某些癌症，但也可能根据组织或疾病以及所涉及的器官部位产生其他影响。阿司匹林最知名的生物学靶点是环氧化酶，它驱动着广泛的功能，包括止血、炎症和免疫调节。新发现的分子和细胞相互作用表明存在其他可调节的功能靶点，而共识分子癌症亚型的存在表明，阿司匹林可能根据肿瘤异质性产生不同的效果。这篇综述重点介绍了药理学方面的新进展和生物药理学方面的创新，这些进展和创新阐明了阿司匹林在癌症化学预防中的潜在作用。
