Chemoprevention backgrounder: Working for a future of cancer chemoprevention

ct. It would be best if promising agents can be screened first," says Arun, an associate professor in the Department of Breast Medical Oncology. "Evidence taken directly from these studies will help move larger chemoprevention studies forward."

Arun is looking for such markers in an M. D. Anderson clinical trial testing use of celecoxib in preventing breast cancer - believed to be the only trial of its kind in the United States. She also is researching how the newest classes of estrogen blockers change the biology of breast cells. To do that, Arun uses a minimally invasive technique known as ductal lavage to collect and examine cells from breast milk ducts. She says that, so far, "COX-2 overexpression is strongly implicated in progression of breast precancer to malignancy."

Retinoic acids also are being tested as a breast cancer chemopreventive. Gordon Mills, M.D., Ph.D., a professor and chair of the Department of Molecular Therapeutics, is examining the effects of retinoic acid and birth control pills on breast and ovarian tissue in patients who have a strong family history of the disease.

Hints that prostate cancer also may respond to a strategy of chemoprevention has lead to the largest cancer prevention study ever undertaken - a study of selenium and vitamin E supplements in 32,400 men across the United States, Canada and Puerto Rico.

Known as SELECT (the Selenium and Vitamin E Cancer Prevention Trial), the trial is based on observations from two previous studies that failed, but which offered a new direction, says Lippman, the national medical oncology leader of the trial, which is expected to take more than a decade.

One earlier study had tested whether selenium, a trace element, could help prevent non-melanoma skin cancer. In the end, skin cancer rates were not reduced, but the expected incidence of prostate cancer fell by two-thirds. The other study explores use of vitamin E to prevent lung cancer, and results showed n

Contact: Nancy Jensen
University of Texas M. D. Anderson Cancer Center

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