Barrett's esophagus: chemoprevention.
The clinical applicability of the experimental data discussed previously remains questionable, and results of clinical studies on chemoprevention in Barrett's esophagus are needed. The utility of selectively targeting acid exposure, ODC, and COX-2 is not clear, and elucidation of that role will be facilitated by a better understanding of the contribution of these factors in the development of Barrett's cancers. The insights already gained into the basic mechanisms of acid exposure, ODC, and COX-2 in the pathogenesis of Barrett's esophagus and esophageal adenocarcinoma hold promise for the development of future therapies aimed at these molecular targets and their signaling pathways. In preclinical studies, the ability of COX-2 selective NSAIDs and DFMO to inhibit carcinogenesis is encouraging. Results of well-designed, prospective clinical studies, however, are still needed to establish the efficacy of potent acid suppression, COX-2 inhibitors, and DFMO in the prevention of this malignancy.
Souza
Rhonda F
RF
Division of Gastroenterology, Dallas VA Medical Center, Dallas, TX 75216, USA. rsouza@airmail.net
Spechler
Stuart J
SJ
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000209:etiology / Q000517:prevention & control*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D000518:Eflornithine / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004945:Esophagoscopy; D005764:Gastroesophageal Reflux / Q000150:complications / Q000517:prevention & control; D006801:Humans; D011230:Precancerous Conditions
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D016861:Cyclooxygenase Inhibitors; D004791:Enzyme Inhibitors; D000518:Eflornithine