CHEMOPREVENTION OF GASTROINTESTINAL CANCER

Gastrointestinal cancer remains a significant public health threat in developed countries. Even with breathtaking gains in our understanding of the molecular underpinnings of the most common GI cancers, it is c lear that the best hope in the foreseeable future lies in the chemopre vention of recurrent cancer and its associated precursors. Colon cance r is an ideal disease for the application of chemopreventive strategie s. The molecular biology of colon cancer has been well studied and it is an excellent model for the development of chemopreventive intervent ions. This fact allows clinical investigators to utilize what is known about discrete biological phases of colon carcinogenesis to tailor cl inical trial protocols that may attenuate a future risk for cancer. Am ong the agents currently in clinical trial testing are anti-oxidants, modulators of metabolism, and anti-proliferatives. Current clinical tr ials have often incorporated the use of biomarkers as intermediate end points to assess the efficacy of particular preventives. The current s tatus of ongoing colon cancer prevention trials suggests that this dis ease, in particular, may well be suited to chemopreventive approaches.