Inflammation and Lung Cancer: Prevention

Abstract

In this chapter, the authors focus on preclinical animal modeling including the basic science connecting inflammation and lung cancer chemoprevention, preclinical testing in animal models, clinical trials, and future directions. Animal models consistently demonstrate that certain inflammatory pathways are clearly important in lung carcinogenesis. Many of these pathways, such as NRF2, PPARγ, and NFκB, are linked to multiple cancer stages (i.e., initiation, promotion, progression, and metastasis) and some (e.g., NRF2, PPARγ) are linked to both pro-and anti-inflammatory pathways depending on the stage. This emphasizes the importance of a stage-dependent approach to therapy. In addition, these early animal studies often identify systemic problems (e.g., cardiac effects of COX-2-specific inhibitors). Although no Phase III trials with lung cancer as the primary endpoint have generated the robust data that would be needed to make recommendations for chemoprevention, both low-dose aspirin and inhaled corticosteroids are of interest for further study. Iloprost has significant preclinical and Phase II data to support further investigation.