Chemoprevention in lung cancer
G. Kotandoula¹, R.C. Winterhalder^2
110th Pulmonary Department, Athens Chest Hospital
²Intensive Care and Pulmonology Department, University of Athens

SUMMARY: Lung cancer is the most common cause of cancer death in developed countries. At the time of diagnosis more than two thirds of the patients present advanced disease (stage IIIb or IV), which is essentially considered incurable. The 5-year survival rate after diagnosis is less than 15%. The high mortality rates pinpoint the strong need for a different approach to lung cancer control, such as chemoprevention and early detection. Chemoprevention, which is defined as the use of agents that inhibit or reverse carcinogenesis, represents therapeutic interventions implemented at early stage carcinogenesis, before cancer becomes invasive. To this end, retinoids have been studied in past and are being considered potential chemopreventive agents. At present, significant research activity is focused on molecular targeted therapies using agents such as EGFR receptor inhibitors and COX inhibitors. Several studies have shown that early detection of lung cancer improves disease outcomes. The identification of intermediate biomarkers of carcinogenesis and the use of laser-induced fluorescence endoscopy (LIFE), sputum cytology and low dose spiral computed tomography have increased diagnostic sensitivity. Comprehensive identification of high-risk groups and targeted preventive interventions, which include conducting relevant clinical trials and screening for lung cancer, are extremely important issues. Pneumon 2003, 16(2):199-208.
Key words: Chemoprevention, lung cancer, biomarkers, dysplasia, drug targets, risk group.
Correspondence: G. Kotandoula, 10th Pulmonary Department, Athens Chest Hospital, 152 Mesogion Ave., GR-115 27, Athens.

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