The state-of-the-art in chemoprevention of skin cancer

The incidence of skin cancer (both melanoma and non-melanoma) continues to grow at an alarming rate. Our chemoprevention strategies include the develo pment of novel agents evaluated by (1) preclinical mechanistic studies in m odels of ultraviolet (UV) radiation-induced skin carcinogenesis; (2) clinic al studies of immunohistochemical surrogate endpoint biomarkers in high-ris k patients: and (3) randomised. placebo-controlled phase I, II and III clin ical chemopreventive trials. Recent clinical results validate this developm ent model. Molecular targets of chemopreventive strategies for melanoma and non-melanoma skin cancers include the ras and activator protein-1 (AP-1) s ignal transduction pathways. A transgenic murine melanoma model has been de veloped for evaluating potential agents in vivo. Agents at various stages o f study include the green tea catechin epigallocatechin gallate (EGCG), the limonene derivative perillyl alcohol, the ornithine decarboxylase inhibito r alpha-difluoromethylornithine (DFMO), selenium, retinoids and salicylates . New chemopreventive agents that can be used to complement sunscreens may result in decreased incidence, morbidity and mortality of skin cancer. (C) 2000 Elsevier Science Ltd. All rights reserved.