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Barriers to preventive therapy for breast and other major cancers and strategies to improve uptake.

DeCensi A, Thorat MA, Bonanni B, Smith SG, Cuzick J - Ecancermedicalscience (2015)

Bottom Line: In this review, we discuss these barriers in detail and propose strategies to overcome them.Future research to improve therapeutic cancer prevention needs to include improvements in the prediction of benefits and harms, and improvements in the safety profile of existing agents by experimentation with dose.In order to move the field of therapeutic cancer prevention forwards, engagement with policymakers to correct research imbalance as well as to remove practical obstacles to implementation is also urgently needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, Genoa 16128, Italy ; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.

ABSTRACT
The global cancer burden continues to rise and the war on cancer can only be won if improvements in treatment go hand in hand with therapeutic cancer prevention. Despite the availability of several efficacious agents, utilisation of preventive therapy has been poor due to various barriers, such as the lack of physician and patient awareness, fear of side effects, and licensing and indemnity issues. In this review, we discuss these barriers in detail and propose strategies to overcome them. These strategies include improving physician awareness and countering prejudices by highlighting the important differences between preventive therapy and cancer treatment. The importance of the agent-biomarker-cohort (ABC) paradigm to improve effectiveness of preventive therapy cannot be overemphasised. Future research to improve therapeutic cancer prevention needs to include improvements in the prediction of benefits and harms, and improvements in the safety profile of existing agents by experimentation with dose. We also highlight the role of drug repurposing for providing new agents as well as to address the current imbalance between therapeutic and preventive research. In order to move the field of therapeutic cancer prevention forwards, engagement with policymakers to correct research imbalance as well as to remove practical obstacles to implementation is also urgently needed.

No MeSH data available.


Related in: MedlinePlus

Key elements for cancer prevention: the ABC paradigm. (From De Censi A, Discussion abstract LBA504, ASCO June 5, 2011 [51].)
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figure2: Key elements for cancer prevention: the ABC paradigm. (From De Censi A, Discussion abstract LBA504, ASCO June 5, 2011 [51].)

Mentions: The key ingredients for the successful progress of cancer prevention are summarised in the ABC (agents–biomarkers, cohorts) paradigm [51] (Figure 2). However, the development of new agents in cancer prevention is hampered by the lack of suitable biomarkers and targets. Establishing breast cancer chemoprevention as standard clinical practice as has been done in cardiovascular medicine will require advances in many different fields, including biomarker research, the development of more powerful tools to identify at risk individuals (cohorts), methods to better communicate the risks and benefits of treatments, and establishing innovative trial designs.


Barriers to preventive therapy for breast and other major cancers and strategies to improve uptake.

DeCensi A, Thorat MA, Bonanni B, Smith SG, Cuzick J - Ecancermedicalscience (2015)

Key elements for cancer prevention: the ABC paradigm. (From De Censi A, Discussion abstract LBA504, ASCO June 5, 2011 [51].)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664508&req=5

figure2: Key elements for cancer prevention: the ABC paradigm. (From De Censi A, Discussion abstract LBA504, ASCO June 5, 2011 [51].)
Mentions: The key ingredients for the successful progress of cancer prevention are summarised in the ABC (agents–biomarkers, cohorts) paradigm [51] (Figure 2). However, the development of new agents in cancer prevention is hampered by the lack of suitable biomarkers and targets. Establishing breast cancer chemoprevention as standard clinical practice as has been done in cardiovascular medicine will require advances in many different fields, including biomarker research, the development of more powerful tools to identify at risk individuals (cohorts), methods to better communicate the risks and benefits of treatments, and establishing innovative trial designs.

Bottom Line: In this review, we discuss these barriers in detail and propose strategies to overcome them.Future research to improve therapeutic cancer prevention needs to include improvements in the prediction of benefits and harms, and improvements in the safety profile of existing agents by experimentation with dose.In order to move the field of therapeutic cancer prevention forwards, engagement with policymakers to correct research imbalance as well as to remove practical obstacles to implementation is also urgently needed.

View Article: PubMed Central - PubMed

Affiliation: Division of Medical Oncology, E.O. Ospedali Galliera, Mura delle Cappuccine 14, Genoa 16128, Italy ; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.

ABSTRACT
The global cancer burden continues to rise and the war on cancer can only be won if improvements in treatment go hand in hand with therapeutic cancer prevention. Despite the availability of several efficacious agents, utilisation of preventive therapy has been poor due to various barriers, such as the lack of physician and patient awareness, fear of side effects, and licensing and indemnity issues. In this review, we discuss these barriers in detail and propose strategies to overcome them. These strategies include improving physician awareness and countering prejudices by highlighting the important differences between preventive therapy and cancer treatment. The importance of the agent-biomarker-cohort (ABC) paradigm to improve effectiveness of preventive therapy cannot be overemphasised. Future research to improve therapeutic cancer prevention needs to include improvements in the prediction of benefits and harms, and improvements in the safety profile of existing agents by experimentation with dose. We also highlight the role of drug repurposing for providing new agents as well as to address the current imbalance between therapeutic and preventive research. In order to move the field of therapeutic cancer prevention forwards, engagement with policymakers to correct research imbalance as well as to remove practical obstacles to implementation is also urgently needed.

No MeSH data available.


Related in: MedlinePlus