Chemoprevention of lung cancers: lessons from CARET, the beta-carotene and retinol efficacy trial, and prospects for the future

  title={Chemoprevention of lung cancers: lessons from CARET, the beta-carotene and retinol efficacy trial, and prospects for the future},
  author={Gilbert S. Omenn},
  journal={European Journal of Cancer Prevention},
  • G. Omenn
  • Published 1 June 2007
  • Medicine
  • European Journal of Cancer Prevention
The objective of this paper was to review the strategies for lung cancer chemoprevention. [] Key Method A retrospective assessment of the major findings from the most informative lung cancer chemoprevention clinical trials [alpha-tocopherol (vitamin E), beta-carotene trial and beta-carotene and retinol efficacy trial] was employed. Both trials and many others showed no benefit from what was once the prime candidate for lung cancer chemoprevention, beta-carotene. Furthermore, both trials found that beta…

Vitamin A and Retinoid Derivatives for Lung Cancer: A Systematic Review and Meta Analysis

There is a lack of evidence to support the use of naturally occuring retinoids for the treatment and prevention of lung cancers, and the rexinoid bexarotene may hold promise for use among a subset of patients, and deserves further study.

Translating Curcumin to the Clinic for Lung Cancer Prevention: Evaluation of the Preclinical Evidence for Its Utility in Primary, Secondary, and Tertiary Prevention Strategies

Preclinical evidence for chemopreventive efficacy of curcumin in models of lung cancer is summarized and stratifies, and the weight of evidence for use of curCumin in lung cancerChemoprevention strategies is adjudged.

The Role of Vitamin E in Prostate Cancer

Considerable evidence now supports the view that the various isoforms of vitamin E have distinct biochemical properties and distinct abilities to modulate oxidative stress, signal transduction pathways, and pathophysiological processes important in carcinogenesis.

Chemopreventive and Anti-Cancer Efficacy of Silibinin Against Growth and Progression of Lung Cancer

The present review focuses on encompassing the efficacy and mechanisms of silibinin against lung cancer, a natural flavonolignan that has been rigorously evaluated for the prevention and growth control of lung cancer through extensive in vitro and in vivo studies.

Potential Micronutrients and Phytochemicals against the Pathogenesis of Chronic Obstructive Pulmonary Disease and Lung Cancer

This work reviewed recent papers probing into the potential of nutrients with respect to lung function preservation and prevention of lung cancer risk, and suggest several hypothetical intervention patterns.

Moving a randomized clinical trial into an observational cohort

The transition process from a randomized clinical trial to the observational Centralized Follow-Up (CFU) study is described, which enabled us to collect additional prostate and other cancer endpoints and longer follow-up on the almost 18,000 participants enrolled.

Green Tea and Its Extracts in Cancer Prevention and Treatment

Green tea as an indicator of as yet undefined parameters in lifestyle, environment and/or ethnicity may explain some of the observed differences between China and other countries, but epidemiological studies thus do not support a cancer protective effect.

Topical tretinoin therapy and all-cause mortality.

An association of topical tretinoin therapy with death is observed, but a causal association that current evidence suggests is unlikely is unlikely.



Chemoprevention of lung cancer: the rise and demise of beta-carotene.

  • G. Omenn
  • Medicine
    Annual review of public health
  • 1998
Beta-carotene and retinoids were the most promising agents against common cancers when the National Cancer Institute mounted a substantial program of population-based trials in the early 1980s. Both

Human lung cancer chemoprevention strategies: Parker B. Francis lecture.

Chemoprevention remains an active, promising strategy, with new hypotheses and new candidate agents, including many already approved as therapies, the most active area currently is focused on selective inhibition of arachidonic metabolism, both Cox-2 and Lox pathways.

Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial.

Results based on the pre-specified analytic method are presented, details about risk factors for lung cancer, and analyses of subgroups and of factors that possibly influence response to the intervention are presented.

Statistical design and monitoring of the Carotene and Retinol Efficacy Trial (CARET).

The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping beta-carotene and retinol supplements.

The previously reported adverse effects of beta-carotene and retinyl palmitate on lung cancer incidence and all-cause mortality in cigarette smokers and individuals with occupational exposure to asbestos persisted after drug administration was stopped although they are no longer statistically significant.

The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers.

No reduction in the incidence of lung cancer among male smokers is found after five to eight years of dietary supplementation with alpha-tocopherol or beta carotene, and this trial raises the possibility that these supplements may actually have harmful as well as beneficial effects.

Lung cancer: genetics of risk and advances in chemoprevention

The authors are poised to learn a great deal about the genetic susceptibility to lung cancer, which will not only allow definition of groups with extremely high risk, but may also yield new insights into processes that determine innate susceptibility or resistance to lung carcinogenesis.

Advances in the biology of lung cancer chemoprevention.

  • F. HirschS. Lippman
  • Biology, Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
Defining highest lung cancer risk (eg, establishing molecular risk models through long-term analyses of high-risk cohorts) will facilitate the clinical development of molecular-targeted prevention that will potentially reduce the enormous burden of lung cancer.

The Carotene and Retinol Efficacy Trial (Caret)

The Carotene and Retinol Efficacy Trial (CARET) is a phase III chemoprevention trial sponsored by the U.S. National Cancer Institute and tested whether the daily combination of 30 mg beta-carotene plus 25,000 International Units (IU) retinyl palmitate would lower the incidence of lung cancer in individuals at high risk for the disease.

Incidence of cancer and mortality following alpha-tocopherol and beta-carotene supplementation: a postintervention follow-up.

The beneficial and adverse effects of supplemental alpha-tocopherol and beta-carotene disappeared during postintervention follow-up, and the preventive effects of alpha-ocopherol on prostate cancer require confirmation in other trials.