In 1976, Sporn has defined
chemoprevention as "the use of pharmacologic or natural agents that
inhibit the development of invasive breast cancer either by blocking the DNA
damage that initiates carcinogenesis, or by arresting or reversing the
progression of premalignant cells in which such damage has already
occurred." Although the precise mechanism or mechanisms that promote a
breast cancer are not completely established, the success of several recent
clinical trials in preventive settings in selected high-risk populations
suggests that chemoprevention is a rational and an appealing strategy. Breast
cancer chemoprevention has focused heavily on endocrine intervention using
selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs).
Achieving much success in this particular setting and new approaches as
low-dose administration are actually under investigations in several topics.
Unfortunately, these drugs are active in prevention of endocrine responsive
lesions only and have no effect in reducing the risk of estrogen-negative
breast cancer. Thus, recently new pathways, biomarkers, and agents likely are
to be effective in this subgroup of cancers and were put under investigation.
Moreover, the identification of new potential molecular targets and the
development of agents aimed at these targets within cancer have already had a
significant impact on advanced cancer therapy and provide a wealth of
opportunities for chemoprevention. This paper will highlight current clinical
research in both ER-positive and ER-negative breast cancer chemoprevention,
explaining the biologic effect of the various agents on carcinogenesis and
precancerous lesions, and finally presenting an excursus on the
state-of-the-art about new molecular targets under investigations in breast
cancer settings.
Source: Breast cancer chemoprevention:
old and new approaches. Cazzaniga M, Bonanni B. J Biomed Biotechnol.
2012;2012:985620.
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