Strategies for prevention of colorectal cancer: Pharmaceutical and nutritional interventions

  • C.D. L
  • D.E. B
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Abstract

Interventions designed to delay or prevent the development of invasive colorectal adenocarcinoma might result in a profound impact on the incidence of and mortality from colorectal cancer. Current developmental efforts focus in two major directions: identification and testing of combination-targeted signal transduction pathway modulators and development of nutriceuticals. Both approaches recognize the heterogeneity of the carcinogenesis process. Combinations of agents (eg, aspirin or sulindac with DFMO, calcium with fiber), which have complementary or synergistic mechanisms or agents with broad spectrum anti-carcinogenic effects can potentially improve upon the effects of single agents and account for redundant signal transduction pathways involved in uncontrolled growth of clonal cells. Preliminary data in rodent systems suggest nutriceuticals or standardized foodstuffs, which contain multiple components, many of which are not identified have synergistic anticarcinogenesis effects. Diet modulation or supplementation with known standardized foodstuffs may be ideal in individuals at risk for colorectal cancer. Current clinical models for colorectal cancer prevention focus upon a pathologic-surrogate endpoint (reducing the recurrence or emergence of adenomas). This surrogate, generally accepted at a regulatory level, might not represent the true malignant progression from normal colonic mucosa to the malignant phenotype. Could the intervention simply prevent the emergence of adenomas that would not have progressed to invasive neoplasia in any event? Despite this major weakness, the adenoma remains the regulatory endpoint for efficacy because the cancer event remains rare, even among individuals selected as high-risk epidemiology but without known, highly pressured genetic-based stress. Over the next decade, the emergence of molecular and proteomic profiling tools have the potential of selecting adenomas that will progress to adenocarcinomas and will allow for investigation to be focused on individuals a t increased risk. Copyright © 2004 by Current Science Inc.

Author-supplied keywords

  • *colorectal carcinoma/dm [Disease Management]
  • *colorectal carcinoma/dt [Drug Therapy]
  • *colorectal carcinoma/pc [Prevention]
  • *colorectal carcinoma/th [Therapy]
  • Curcuma longa/ae [Adverse Drug Reaction]
  • Curcuma longa/dt [Drug Therapy]
  • Curcuma longa/pd [Pharmacology]
  • DNA fingerprinting
  • abdominal pain/si [Side Effect]
  • acetylsalicylic acid/ae [Adverse Drug Reaction]
  • acetylsalicylic acid/cb [Drug Combination]
  • acetylsalicylic acid/cm [Drug Comparison]
  • acetylsalicylic acid/ct [Clinical Trial]
  • acetylsalicylic acid/dt [Drug Therapy]
  • acetylsalicylic acid/it [Drug Interaction]
  • acetylsalicylic acid/pd [Pharmacology]
  • acetylsalicylic acid/pe [Pharmacoeconomics]
  • adenocarcinoma/dt [Drug Therapy]
  • adenocarcinoma/pc [Prevention]
  • adenocarcinoma/th [Therapy]
  • alpha carotene/ct [Clinical Trial]
  • alpha carotene/dt [Drug Therapy]
  • alpha carotene/pd [Pharmacology]
  • alpha tocopherol/ae [Adverse Drug Reaction]
  • alpha tocopherol/cb [Drug Combination]
  • alpha tocopherol/ct [Clinical Trial]
  • alpha tocopherol/dt [Drug Therapy]
  • alpha tocopherol/pd [Pharmacology]
  • anthocyanin
  • antineoplastic activity
  • ascorbic acid/cb [Drug Combination]
  • ascorbic acid/ct [Clinical Trial]
  • ascorbic acid/dt [Drug Therapy]
  • ascorbic acid/pd [Pharmacology]
  • beta carotene/ae [Adverse Drug Reaction]
  • beta carotene/cb [Drug Combination]
  • beta carotene/ct [Clinical Trial]
  • beta carotene/dt [Drug Therapy]
  • beta carotene/pd [Pharmacology]
  • bleeding/si [Side Effect]
  • calcium carbonate/ae [Adverse Drug Reaction]
  • calcium carbonate/cb [Drug Combination]
  • calcium carbonate/dt [Drug Therapy]
  • calcium carbonate/pd [Pharmacology]
  • cancer epidemiology
  • cancer genetics
  • cancer growth
  • cancer incidence
  • cancer invasion
  • cancer mortality
  • cancer recurrence
  • carcinogenesis
  • celecoxib/ae [Adverse Drug Reaction]
  • celecoxib/ct [Clinical Trial]
  • celecoxib/dt [Drug Therapy]
  • celecoxib/pd [Pharmacology]
  • cell clone
  • cenlidac
  • clinical trial
  • colon adenoma
  • cost effectiveness analysis
  • curcumin/ae [Adverse Drug Reaction]
  • curcumin/dt [Drug Therapy]
  • curcumin/pd [Pharmacology]
  • cyclooxygenase 2 inhibitor/ae [Adverse Drug Reacti
  • cyclooxygenase 2 inhibitor/ct [Clinical Trial]
  • cyclooxygenase 2 inhibitor/dt [Drug Therapy]
  • cyclooxygenase 2 inhibitor/pd [Pharmacology]
  • diet supplementation
  • drug efficacy
  • drug induced disease/si [Side Effect]
  • drug mechanism
  • drug potentiation
  • eflornithine/ae [Adverse Drug Reaction]
  • eflornithine/cb [Drug Combination]
  • eflornithine/ct [Clinical Trial]
  • eflornithine/dt [Drug Therapy]
  • eflornithine/it [Drug Interaction]
  • eflornithine/pd [Pharmacology]
  • ellagic acid
  • erosion/si [Side Effect]
  • ferulic acid
  • flu like syndrome/si [Side Effect]
  • folic acid/cb [Drug Combination]
  • folic acid/cm [Drug Comparison]
  • folic acid/ct [Clinical Trial]
  • folic acid/dt [Drug Therapy]
  • folic acid/pd [Pharmacology]
  • food composition
  • gastrointestinal toxicity/si [Side Effect]
  • growth regulation
  • high risk patient
  • human
  • hyperbilirubinemia/si [Side Effect]
  • lung cancer/si [Side Effect]
  • lycopene/dt [Drug Therapy]
  • lycopene/pd [Pharmacology]
  • lysine acetylsalicylate/ct [Clinical Trial]
  • lysine acetylsalicylate/dt [Drug Therapy]
  • lysine acetylsalicylate/pd [Pharmacology]
  • malignant transformation
  • molecular systematics
  • nonhuman
  • nutrition
  • pain/si [Side Effect]
  • pancreas cancer/si [Side Effect]
  • pharmaceutical care
  • phenol derivative
  • phenotype
  • phytosterol
  • proanthocyanidin derivative
  • protein targeting
  • proteomics
  • retinol/ae [Adverse Drug Reaction]
  • retinol/ct [Clinical Trial]
  • retinol/dt [Drug Therapy]
  • retinol/pd [Pharmacology]
  • review
  • rodent
  • selenium/ct [Clinical Trial]
  • selenium/pd [Pharmacology]
  • selenium/to [Drug Toxicity]
  • signal transduction
  • sitosterol
  • stomatitis/si [Side Effect]
  • stress
  • sulindac/ae [Adverse Drug Reaction]
  • sulindac/cb [Drug Combination]
  • sulindac/ct [Clinical Trial]
  • sulindac/dt [Drug Therapy]
  • sulindac/it [Drug Interaction]
  • sulindac/pd [Pharmacology]
  • thrombophlebitis/si [Side Effect]
  • tumor recurrence/si [Side Effect]
  • unclassified drug
  • vitamin D/cb [Drug Combination]
  • vitamin D/cr [Drug Concentration]
  • vitamin D/ct [Clinical Trial]
  • vitamin D/dt [Drug Therapy]
  • vitamin D/pd [Pharmacology]
  • vitamin blood level
  • zinc

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Authors

  • Lao C.D.

  • Brenner D.E.

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