Despite the smoking cessation programs and recent advances in multimodality treatment, squamous significant public health problem. Among the new strategies of tumour therapy, chemoprevention is a promising emerging approach which involves the use of natural or chemical agents to reverse or suppress the progression of a premalignancy to invasive cancer. Biological concepts including 'multistep carcinogenesis' and 'field cancerisation' strongly support the rationale for using chemopreventive approaches in HN cancer. This strategy aims to prevent and control malignant transformation from a mechanistic approach derived from chemical and biological researche that include pre-clinical in vitro and in vivo studies, intermediate-endpoint biomarker investigation, and clinical trials, Cancer chemoprevention strategies in the HN currently involve the reversal of oral pre-invasive lesions and the prevention of second primary tumours after curative therapy of early primary cancers. The vast majority of studies in this area involve retinoids, natural derivatives and synthetic analogues of vitamin A, which are by far the most studied and active agents in HN chemoprevention. The anti-carcinogenic activity of retinoids appears to be the result of complex regulatory effects on cell differentiation, cell proliferation, and apoptosis. The retinoid chemopreventive approach has been supported by results from laboratory studies as well as epidemiological findings; a significant clinical activity in reversing oral premalignancy and in reducing. second primary tumours development has been established in a series of randomised trials. Trials of drug interventions within the carcinogenic process are tightly linked and proceed in parallel with intensive study of the biology of carcinogenesis and mechanism of retinoid action. Further advances in molecular epidemiology and molecular genetics in epithelial carcinogenesis will allow the development of valid biomarkers, which can be used both in risk assessment and as intermediate markers of response to intervention.
|Number of pages||7|
|Journal||FORUM - Trends in Experimental and Clinical Medicine|
|Issue number||1 SUPPL. 2|
|Publication status||Published - 1997|
- Head and neck cancer
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