The need for preventive drugs and vaccines in global cancer

In sweden for example much of the decline is

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In Sweden, for example, much of the decline is attributable to screening, but some of the decline is due to early detection and treatment (Ponten et al ., 1995). Commitment to disease prevention from pharmaceutical industry Because of the detailed knowledge we have gained of the carcinogenesis process, and the role of various aetiological and protective factors, it is now a widely accepted concept that cancer is largely a preventable disease. In addition to cancer therapy and primary prevention of cancer, a new paradigm of cancer chemoprevention has emerged. As elo- quently argued by Sporn and Suh (2002), cancer cures for major malignancies unfortunately remain very low, despite many advances in therapy, and great expectations from molecular gene therapy may be unduly naive. Thus, primary and secondary preventive efforts continue to be of major impor- tance, and many authors have stressed the potential utility of chemical compounds, which can suppress processes responsible for tumourigenesis. Chemo- prevention aims to prevent the progression of the carcinogenic process at a preclinical stage, and even revert the process. There have already been some successful clinical trials, e.g., with oestrogen analo- gues tamoxifen and raloxifene against breast cancer (see Greenwald, 2002). At the same time, tamoxifen seems less than ideal for `healthy’ women, because it has adverse consequences, which even though they are infrequent, manifest themselves in the large number of women who are destined never to develop breast cancer (Gail et al ., 1999; Love, 2001). In addition, compounds such as aspirin and aspirin type NSAID drugs offer great promise (Vainio et al ., 2002; Imperiale, 2003). This knowl- edge allows us to set the framework for cancer prevention research that includes biomarkers of early responses, research on biological mechanisms underlying putative cancer relationships and iden- tification of the molecular targets of cancer pre- vention. Pharmaceutical companies continue to spend billions of dollars to market oncological drugs that will make only small, incremental improve- ments in cancer treatment. By contrast, the indus- try has balked at making major investments in chemoprevention research ¡ / the kind that might lead to agents that would stop cancer in its most formative stages. The drug industry has committed to chemoprevention in several areas ¡ / osteoporosis, lipid reduction and transplant rejection ¡ / but not in cancer. Among the major obstacles holding drug makers back is the notion that the cancer disease process is probably more complex and heteroge- neous than many other chronic disease; predictive markers that would identify individuals at risk remain elusive, which makes identifying people who would benefit from chemoprevention akin to looking for a needle in a haystack; the regulatory approval process is uncertain and could become even more lengthy; and conventional wisdom holds that `nobody gets paid to practice prevention’.
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  • Spring '10
  • Macdon

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