Lung cancer remains a major cause of mortality worldwide, despite advances in surgery,
radiotherapy and
chemotherapy. Most patients present with advanced disease, and early detection approaches are still experimental.
Chemoprevention strategies are therefore essential.
Chemoprevention can be defined as the use of specific natural or synthetic chemical agents to reverse, suppress or prevent progression to invasive
cancer. The present review will provide an update on
lung cancer clinical
chemoprevention trials as well as the molecular basis of lung
carcinogenesis. A better knowledge of lung
carcinogenesis is obviously fundamental to improve
chemoprevention strategies. Identification of molecular defects involved in premalignant lesions and/or invasive
cancer could lead to clinical studies with new molecular-targeted agents (mainly
tyrosine kinase inhibitors, farnesyl-
transferase inhibitors and/or antiangiogenic molecules) and the development of surrogate
biomarkers. Such
biomarkers would be essential to detect high-risk patients, select adequate
chemoprevention strategies and monitor drug efficacy. New
chemoprevention trials are planned with collaborative efforts of researchers involved in fundamental or clinical studies.