CLINICAL-MODELS OF CHEMOPREVENTION FOR THE ESOPHAGUS

The two principal types of esophageal cancer are (1) adenocarcinoma, d erived from Barrett's metaplasia, and (2) squamous cell carcinoma, whi ch arises from epithelial dysplasia. Adenocarcinoma occurs frequently in the United States and rarely in the Middle East and Far East, where as the opposite is true for esophageal squamous cell carcinoma. Both c ancers have a poor prognosis. Chemoprevention is likely to be a viable approach to reduce the incidence of and mortality from these diseases . Approaches for the chemoprevention of esophageal adenocarcinoma and squamous cell carcinoma are presented in this article, and events asso ciated with both the initiation and promotion/progression stages of th ese diseases are addressed. The results of completed trials for the ch emoprevention of these cancers are summarized, and suggestions are mad e for future trials involving additional strategies and endpoints.