Chemoprevention Strategies in Lung Carcinogenesis

¹ The Department of Medical Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston.

Despite local and systemic therapy and smoking cessation programs, lung cancer remains the major cause of cancer-related death in the United States. Chemoprevention is an exciting and promising investigational modality for the control of lung carcinogenesis. Future directions for this research will hinge on forthcoming clinical results of ongoing phase III trials and continued advances in the epidemiologic and biologic study of lung carcinogenesis.

Current and planned lung cancer chemoprevention studies owe their designs in large part to extensive work already completed in the related system of head and neck carcinogenesis. Because of encouraging results in the control of SPT associated with head and neck cancers, hopes are high for controlling SPT in the lung in recently designed phase III trials. Second primary tumors are now a major problem in early stage disease and will become an even greater concern as primary therapy advances improve long-term survival rates in patients with later stage disease. Conducted on a multicenter and intergroup basis, these trials are available to early stage NSCLC patients throughout the United States and Europe (Table 2).

The results of the current series of SPT lung chemoprevention trials will determine future multimodality strategies in lung cancer, which may include primary and adjuvant therapy followed by long-term chemoprevention. Such an integrated approach may ultimately lead to major improvements in the survival of patients with lung cancer.