Singh D K, Lippman S M
Department of Gynecologic Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, USA.
Oncology (Williston Park). 1998 Nov;12(11):1643-53, 1657-8; discussion 1659-60.
Cancer chemoprevention is the use of specific natural or synthetic substances with the objective of reversing, suppressing, or preventing carcinogenic progression to invasive cancer. Currently, numerous chemopreventive agents are in various stages of development and testing. Part 1 of this two-part series provides an overview of issues unique to chemoprevention trials, including the use of surrogate biomarkers as end points. This is followed by a discussion of the retinoids, such as all-trans-retinoic acid (ATRA [Vesanoid]), 9-cis-retinoic acid (9cRA), and isotretinoin (Accutane), and the carotenoids (e.g., beta-carotene and lycopene) and other "classic" antioxidants (e.g., vitamins E and C and selenium). Research on these agents will be delineated by disease site when applicable. Part 2, which will appear in next month's issue, will focus on hormonally mediated chemopreventive agents, such as tamoxifen (Nolvadex), finasteride (Proscar), oral contraceptives, and dehydroepiandrosterone (DHEA). Part 2 also will cover nonantioxidant natural agents, such as calcium, the polyphenols, the isothiocyanates, and genistein; nonsteroidal anti-inflammatory drugs (NSAIDS), such as celecoxib, sulindac sulfone, and aspirin; difluromethylornithine (DFMO [Eflornithine]); oltipraz; and N-acetylcysteine.
癌症化学预防是指使用特定的天然或合成物质，目的是逆转、抑制或预防致癌过程发展为浸润性癌症。目前，众多化学预防剂正处于不同的开发和测试阶段。这个两部分系列的第1部分概述了化学预防试验特有的问题，包括使用替代生物标志物作为终点。接下来讨论了维甲酸类药物，如全反式维甲酸（ATRA [维甲酸]）、9-顺式维甲酸（9cRA）和异维甲酸（异维A酸），以及类胡萝卜素（如β-胡萝卜素和番茄红素）和其他“经典”抗氧化剂（如维生素E、维生素C和硒）。适当时，将按疾病部位阐述对这些药物的研究。第2部分将于下个月的期刊发表，将重点关注激素介导的化学预防剂，如他莫昔芬（诺瓦得士）、非那雄胺（保列治）、口服避孕药和脱氢表雄酮（DHEA）。第2部分还将涵盖非抗氧化天然药物，如钙、多酚、异硫氰酸盐和染料木黄酮；非甾体抗炎药（NSAIDs），如塞来昔布、舒林酸砜和阿司匹林；二氟甲基鸟氨酸（DFMO [依氟鸟氨酸]）；奥替普拉；以及N-乙酰半胱氨酸。
