Predicting success in cancer prevention trials
The tremendous public health burden resulting from more than 200000 new diagnoses and 165000 deaths each year that are attributable to tobacco-related cancers arising in the lung and upper aerodigestive tract requires new treatment and prevention strategies.
One such approach is chemoprevention, which relies on interventions during early phases of carcinogenesis to reduce the incidence of invasive cancer and, ultimately, to reduce cancer-related morbidity and mortality.
Definitive studies of investigational chemopreventive agents typically are carried out in phase III clinical trials, where cancer incidence or mortality serves as the primary end point.
However, the high cost and lengthy duration of phase III studies limit their application to only the most promising agents.
How can we improve our ability to perform clinically meaningful cancer prevention studies in a more cost-effective and time-efficient manner? This issue of the Journal reports two strategies that address this question - the use of molecular intermediate end points in phase II trials (2) and the use of genotypic analysis to identify the most appropriate cohorts for intervention.
See also All-Trans-Retinoic Acid (ATRA - analogues and/or derivatives).