Pharmacologic and Chemopreventive Strategies in Cancer Prevention
Pharmacologic and chemopreventive interventions play a crucial role in reducing cancer risk, particularly for individuals at high genetic, molecular, or environmental susceptibility. This session explores the evidence-based use of drugs and biologics to prevent the initiation, progression, or recurrence of malignancies, integrating molecular profiling, risk stratification, and clinical guidelines. Agents such as selective estrogen receptor modulators (SERMs), aromatase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and metformin are discussed for their chemopreventive properties in breast, colorectal, and other cancers. Mechanisms of action, including modulation of hormonal pathways, inhibition of inflammatory cascades, suppression of cell proliferation, and induction of apoptosis, are examined to understand how pharmacologic interventions target early carcinogenic processes. The session emphasizes patient selection using biomarkers, genetic testing, and risk models to optimize efficacy and minimize adverse effects. Clinical trial evidence, including randomized controlled studies and long-term follow-up data, is reviewed to guide decision-making in preventive therapy. Safety monitoring, dose optimization, adherence support, and management of side effects are critical components of effective chemoprevention programs. Integration with lifestyle interventions, immunopreventive strategies, and routine screening enhances overall cancer risk reduction. Ethical considerations, including informed consent, patient autonomy, and equitable access, underpin the use of pharmacologic preventive measures. Emerging areas such as targeted small molecules, epigenetic modifiers, and combination preventive regimens are highlighted for their potential to expand personalized prevention. By combining molecular insights, clinical evidence, and individualized risk assessment, pharmacologic and chemopreventive strategies provide a proactive approach to cancer prevention, reducing incidence and improving long-term outcomes while complementing screening, immunoprevention, and lifestyle-based interventions.