New Directions in Lung Cancer: Chemoprevention

Approximately 177,000 new cases of lung cancer will be diagnosed in 1995 in the United States, mak­ ing it the third most prevalent cancer site after prostate and breast. However, approximately 158,700 patients will die of lung cancer in the United States in 1996, more than the combined total of the next three leading sites of cancer death (colon-rectum, breast, prostate). The 5-year survival rate from lung cancer has improved from 9% in the early 1970s to 13% by the early 1990s. Although this represents a 44% improvement, clearly substantial work remains in a field where the 5-year mortality rate remains at 87%. Though ongoing clinical trials continue to investigate novel models of combined modality or single-agent therapy, much of the excitement in this field has revolved around the progress achieved over the last decade in upper aerodigestive tract (UADT) chemoprevention. This work has resulted from a rich collaboration between basic scientists and clini­ cal investigators that serves as a paradigm for translational research. As both basic scientists and clinical investigators proceed in their generally divergent pursuits, it is worth examining a model in which col­ laborative investigation has focused on a better appreciation of the biology of cancer cells as well as options for primary prevention.