Short-term Intervention to Revert Premalignant Lesions as Strategy to Prevent Gastrointestinal Cancers

Abstract

"Prevention might be better than treatment in cancer treatment" is brief conclusion drawn from war on cancer through National Cancer Act of 1971 by U.S. President Richard Nixon. However, the clinical practice of chemoprevention is still in its infancy in spite of a wealth of data showing its effectiveness in experimental animals as well as in vitro mechanism research. Recent advances in either high throughput analysis including cancer genomes and tailored medicine or molecular targeted therapeutics, preventive strategies also should be changes as previous preventive strategies including phytoceuticals, life-style modification, and some empirical agents. Furthermore, molecular targeted therapeutics achieved high goal of effectiveness under the concept of therapeutic or preventive "synthetic lethality", of which extended application can be included within the scope of chemoprevention. Here, we will summarize several recent advances in chemopreventive strategy objected to justify optimism that chemoprevention will be an effective approach for the control of human cancer. siTRP (short-term intervention to revert premalignancy) strategy will be introduced for cancers in gastroenterology.

Keywords: Chemoprevention; Human cancer; Phytoceuticals; Synthetic lethality; siTRP.

Fig. 1.

Great achievement of chemoprevention by Prof. Hong WK (Univ of Texas MD Anderson Cancer Center). Prof. Hong WK (Univ of Texas MD Anderson Cancer Center) first tried the application of retinoic acid as differentiation therapy to revert leukoplakia, a precancerous lesion occurring at buccal area and achieve the disappearance of premalignant lesion.

Fig. 2.

siTRP (short-term intervention To Revert Premalignancy). siTRP aimed for chemoprevention via regulating Warburg effect as well as cancer quiescence.

Fig. 3.

Stem cells application for siTRP. (A) MSCs can afford detouring paths to carcinogenesis or delaying carcinogenesis via anti-inflammatory, EMT regulation, and differentiation induction. (B) Rejuvenation of H. pylori-associated chronic atrophic gastritis is achieved with long-term administration of Korean red ginseng, anti-malarial drug chloroquine, special exctracts from garlic, and MSCs. (C) Chemoprevention of colitis-associated cancer with special molecular targets, e.g, anti-oxidative and anti-inflammatory action with 8-OHdG, selective apoptosis induction with PPI, cancer metabolism using FASN inhibitor, and rejuvenating activity of MSCs.