Bostwick D G
Mayo Clinic, Department of Pathology, Rochester, MN 55905.
J Cell Biochem Suppl. 1994;19:191-6.
Chemoprevention trials usually target healthy populations and employ non-toxic chemicals in an effort to eliminate, reduce, or reverse premalignant lesions or early cancer. Recent efforts have been directed at short-term Phase II trials which rely on changes in surrogate endpoint biomarkers rather than cancer incidence reduction as an endpoint. Chemopreventive agents are chosen that are likely to produce a modulating effect on one or more biomarkers in prostate cancer, including extent and grade of morphometric, genetic, proliferative, differentiative, and regulatory biomarkers. Five target populations appear to have the greatest promise in chemoprevention trials for prostate cancer: (1) Patients with high-grade prostatic intraepithelial neoplasia, a microscopic lesion which is the likely precursor of some prostate cancers; (2) patients with early cancer treated by watchful waiting; (3) patients with cancer waiting for prostatectomy; (4) men at high risk of developing prostate cancer; and (5) men from the general population (normal risk of prostate cancer).
化学预防试验通常针对健康人群，并使用无毒化学物质，以消除、减少或逆转癌前病变或早期癌症。最近的努力主要集中在短期II期试验上，这些试验依赖替代终点生物标志物的变化，而不是以降低癌症发病率作为终点。选择的化学预防剂可能会对前列腺癌的一种或多种生物标志物产生调节作用，包括形态计量学、遗传学、增殖、分化和调节生物标志物的程度和分级。在前列腺癌化学预防试验中，有五个目标人群似乎最有前景：（1）高级别前列腺上皮内瘤变患者，这是一种微观病变，可能是某些前列腺癌的前体；（2）通过观察等待治疗的早期癌症患者；（3）等待前列腺切除术的癌症患者；（4）患前列腺癌风险高的男性；（5）一般人群中的男性（患前列腺癌风险正常）。
