Chemoprevention Strategies
Here at the University of Wisconsin Comprehensive Cancer Center we
are conducting research in the areas of chemoprevention, early events
in carcinogenesis, and biological markers of tumor recurrence and progression
in bladder cancer and other genitourinary malignancies.
We are particularly interested in evaluating agents which may prolong
the interval to tumor recurrence and progression. Based on laboratory
data and recent clinical trials, agents which show great promise in
chemoprevention include DFMO and cyclooxygenase (COX)-2 selective inhibitors.
These agents are being evaluated in patients at high risk for tumor
recurrence and progression, such as those with carcinoma in situ or
high grade superficial bladder cancer. The ability to more accurately
predict which patients with superficial bladder cancer will progress
will also allow us to treat these patients more effectively. This research
will hopefully enhance bladder-sparing approaches for treating bladder
cancer, in which fewer patients with superficial bladder cancer will
ultimately require radical cystectomy.
Here at the University of Wisconsin Comprehensive Cancer Center, we
have the resources to build a program in chemoprevention research, and
as a tertiary referral center, many patients with genitourinary cancers
such as bladder cancer may benefit from this research. It is our hope
that these research efforts will lead to the prevention and early detection
of bladder cancer, more accurate staging, appropriate patient selection
for treatment, and more effective therapies.
We are also conducting clinical cancer prevention trials in bladder
and prostate cancer to evaluate the effects of putative chemoprevention
agents. One of these trials is designed to evaluate the effects of a
vitamin D analogue on intermediate biomarker expression in prostate
cancer. Furthermore, a bladder cancer chemoprevention trial evaluating
difluoromethylornithine (DFMO) in the prevention of superficial bladder
cancer has recently been completed. To further develop our understanding
of how these agents and dietary supplements work in reducing or preventing
the development of cancer, we are now developing a cancer chemoprevention
trial to evaluate the effects of dietary soy supplements in bladder
cancer.
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