Lung cancer chemoprevention: current status and future prospects.
Lung cancer chemoprevention: current status and future prospects.
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DOI：
10.1038/nrclinonc.2013.64
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发表时间：
2013-06
期刊：
影响因子：
--
通讯作者：
Miller YE
中科院分区：
文献类型：
--
作者：
Keith RL;Miller YE
肺癌是全球癌症死亡的主要原因，使其成为化学预防的有吸引力的疾病。虽然避免吸烟和戒烟对肺癌的发展影响最大，但化学预防可能被证明是非常有效的，特别是在前吸烟者中。化学预防是使用药剂来逆转或抑制癌发生，并已成功地应用于其他常见的恶性肿瘤。尽管以前的肺癌化学预防研究未能确定有效的药物，但我们现在有能力确定高危人群，我们对肺肿瘤和癌前生物学的理解继续向前发展。有不同的组织学病变可重复分级为非小细胞肺癌的前驱病变，腺癌也存在类似的前驱病变。这些癌前病变是针对化学预防剂在目前的试验，并将继续在未来的研究。此外，正在研究和验证预测风险和对靶向药物反应的生物标志物。在这篇综述中，我们讨论了化学预防的原理，来自临床前模型的数据，已完成的临床试验和观察性研究，并描述了新的靶向途径的新治疗方法和未来的化学预防努力。
Lung cancer is the leading cause of cancer death worldwide, making it an attractive disease for chemoprevention. Although avoidance of tobacco use and smoking cessation will have the greatest impact on lung cancer development, chemoprevention could prove to be very effective, particularly in former smokers. Chemoprevention is the use of agents to reverse or inhibit carcinogenesis and has been successfully applied to other common malignancies. Despite prior studies in lung cancer chemoprevention failing to identify effective agents, we now have the ability to identify high-risk populations, and our understanding of lung tumour and premalignant biology continues to advance. There are distinct histological lesions that can be reproducibly graded as precursors of non-small-cell lung cancer and similar precursor lesions exist for adenocarcinoma. These premalignant lesions are being targeted by chemopreventive agents in current trials and will continue to be studied in the future. In addition, biomarkers that predict risk and response to targeted agents are being investigated and validated. In this Review, we discuss the principles of chemoprevention, data from preclinical models, completed clinical trials and observational studies, and describe new treatments for novel targeted pathways and future chemopreventive efforts.