Chemoprevention of oral cancer: the need for effective biological monitoring.
A major limiting factor in the successful implementation of chemoprevention for oral cancer has been the lack of suitable endpoints to measure efficacy and success of clinical trials. To depend on the measure of the ultimate goal of such trials, namely cancer incidence as an endpoint has serious feasibility problems including a need for large numbers of participants, long periods of follow up and high costs. The application of selected biological markers as intermediate endpoints to reveal responses to chemopreventive regimens within a limited time frame is therefore an attractive concept. By serving as surrogates for cancer they could become valuable tools for monitoring patient compliance, defining the process of carcinogenesis and evaluating effects of the chemopreventive agents on tumour progression. This paper examines various biological markers of oral carcinogenesis and their relevance to chemoprevention trials. If validated, these biological markers could take oral cancer chemoprevention to new frontiers and help fulfil the ultimate goal of disease prevention through intervention.
Pillai
M R
MR
Division of Laboratory Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala State, India.
Ravi
D
D
Nair
M K
MK
D014408:Biomarkers, Tumor; D002338:Carotenoids / Q000097:blood / Q000627:therapeutic use; D018890:Chemoprevention; D002986:Clinical Trials as Topic; D004273:DNA, Neoplasm / Q000032:analysis; D006133:Growth Substances / Q000032:analysis; D006801:Humans; D007633:Keratins / Q000032:analysis; D007972:Leukoplakia, Oral / Q000188:drug therapy; D015162:Micronucleus Tests; D009062:Mouth Neoplasms / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care / Q000379:methods; D012176:Retinoids / Q000097:blood / Q000627:therapeutic use
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D006133:Growth Substances; D012176:Retinoids; D002338:Carotenoids; D007633:Keratins