BCAN Think Tank session 3: Prevention of bladder cancer

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• 作者：Seth P. Lerner ; H. Barton Grossman ; Edward M. Messing ; Adam S. Kibel ; Andrew Stephenson ; Jason R. Gee ; Michael A. O'Donnell ; Robert D. Reid ; Ashish M. Kamat ; Howard L. Parnes ; Margaret G. House
• 关键词：Bladder cancer ; Chemoprevention ; Smoking cessation ; Second primary tumors ; Bacille Calmette-Guerin ; Biomarkers
• 刊名：Urologic Oncology: Seminars and Original Investigations
• 出版年：2010
• 出版时间：May-June 2010
• 年：2010
• 卷：28
• 期：3
• 页码：338-342
• 全文大小：255 K

文摘

The Bladder Cancer Think Tank III brought together a multidisciplinary group of clinician scientists, patient advocates, representatives from the National Cancer Institute, and Industry leaders to discuss the current state of the field in urothelial cancer and to develop strategies to move forward. This paper summarizes the session devoted to prevention. Experts sought to define primary, secondary, and tertiary prevention and discussed clinical trials performed to date testing retinoids, difluoromethylornithine, celecoxib, and other oral agents in a tertiary prevention setting following transurethral resection with or without intravesical therapy. Urologists practice tertiary prevention in the form of intravesical therapy, and strategies were discussed to identify biomarkers, including urinary cytokines and pathway single nucleotide polymorphism analysis associated with response to treatment. Optimizing delivery of intravesical chemotherapy to the target tissue with simple pharmacologic manipulations or packaging drugs in nanoparticles may improve treatment outcome. Defining a premalignant lesion should be a focus of future research as a strategy for early detection and secondary prevention. Cigarette smoking is the most prevalent risk factor for urothelial cancer, and emphasis was placed on smoking cessation as a powerful tool to reduce the burden of urothelial cancer, and the central role physicians must play in educating patients and providing resources. There is a strong need for research to develop markers of disease initiation and progression. These markers, combined with histories of environmental exposure to bladder carcinogens, may provide a tool to identify patients who will benefit from primary prevention.