Lippman S M, Benner S E, Hong W K
Department of Thoracic/Head and Neck Medical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1993 Aug 1;72(3 Suppl):984-90. doi: 10.1002/1097-0142(19930801)72:3+<984::aid-cncr2820721306>3.0.co;2-0.
High incidence and low survival rates of many epithelial cancers remain beyond the control of established preventive and therapeutic modalities. Chemoprevention is a new approach under study that involves the intervention within the premalignant process with specific chemical agents to reverse carcinogenesis and prevent the development of invasive cancer. The two biologic concepts that underlie this research are multistep carcinogenesis and field carcinogenesis. Major clinical issues include trial design and drug development in head and neck, lung, and breast cancer chemoprevention. Within the area of trial design, intermediate end point biomarkers will become very important for providing biologic insights in the short term and greater trial efficiencies in the long term. Drugs that are under the strongest investigation include retinoids and beta-carotene in the head and neck and lung, calcium in the colon, and tamoxifen in the breast. This new field has the potential to make an important contribution toward increasing our control over many deadly epithelial cancers Cancer 1993; 72:984-90.
许多上皮癌的高发病率和低生存率仍然无法通过现有的预防和治疗手段得到控制。化学预防是一种正在研究的新方法，它涉及在前癌过程中使用特定化学试剂进行干预，以逆转致癌过程并预防浸润性癌症的发生。这项研究的两个生物学概念是多步骤致癌作用和场致癌作用。主要的临床问题包括头颈癌、肺癌和乳腺癌化学预防的试验设计和药物开发。在试验设计领域，中间终点生物标志物对于在短期内提供生物学见解以及从长期来看提高试验效率将变得非常重要。研究力度最大的药物包括头颈癌和肺癌中的视黄醇和β-胡萝卜素、结肠癌中的钙以及乳腺癌中的他莫昔芬。这个新领域有可能为增强我们对许多致命上皮癌的控制做出重要贡献 《癌症》1993年；72:984 - 90
