Chemopreventive agents in oral premalignancy: A medical management review

Abstract

A BSTRACT Aims and Objective: The term chemoprevention denotes the use of specific natural or synthetic chemical agents to prevent carcinogenesis. Chemoprevention may help delay the process of carcinogen activation and prevent the conversion of preneoplastic cells. These agents play an active role in the secondary level of prevention and reduce malignancy-associated morbidity and mortality. A new term, “prophylactic antioxidant therapy,” was coined and proposed. This review has assessed all major chemopreventive agents used for oral premalignancy and malignant conditions, which will reduce the economic burden on the patients. Materials and Methods: A systematic literature search was performed using PubMed, Medline, Embase, Cochrane Library, and EBSCO search, with language restriction to English. The search incorporated published literature from 1990 to 2018 using the medical subject heading terms. Literature search was performed using the following keywords: Chemoprevention, Premalignancy, and Oral Malignancy. Results: Of 99 publications related to the search strategy, 45 full articles relevant to the chemopreventive agents in premalignacy and oral malignancy were acquired for further inspection. Of the 45 articles, 30 met the inclusion criteria. Data were collected, and a brief summary of the studies regarding different chemopreventive agents that were most commonly used in oral premalignancy and malignancies was written. Conclusion: This review suggests administration of major chemopreventive agents for superior prognosis in individuals with an elevated risk of premalignancy and malignancy.

Oral cancer chemoprevention: A review

“…Alpha -tocopherol (the only biologically active form of vitamin E) and Vitamin C are free radicle scavengers which -cell cycle arrest -suppression of cell proliferation -induces apoptosis -induces differentiation -reduction of inflammation and angiogenesis -inhibition of adhesion. Invasion and metastasis 0.5, 1.0, 2.5, and 5 g/day for 29 days significantly reduced the levels of insulin like growth factor 1 and insulin-like growth factor binding protein 3 in plasma [15].…”

“…Topical chemopreventive agents are frequently employed in the treatment of oral potentially malignant lesions as they are easy to administer with minimal systemic toxicity. However, they may not take care of the entire cancer field as they act locally [15].…”

“…Aspirin NSAIDS -NF-κb signaling in Carcinogenesis 81-325 mg once a day [15]. Indomethacin NSAIDS -Antineoplastic activity at low doses.…”

“…-Reduces cellular Proliferation -induces apoptosis 7.5 mg/kg daily for 21 days and repeat therapy for every 28 days [15]. Atorvastatin HMG CO-A reductase inhibitors -Induces apoptosis -cell-cycle G1 arrest -autophagy, resulting in reduced cell proliferation 20 mg/night for 2 years during radiotherapy, effective in nasopharyngeal carcinoma [15].…”

“…-combination of vitamin E with lycopene and selenium has been found to be an effective management strategy for oral premalignant lesions [15].…”