Lung Cancer Chemoprevention

Lung cancer is the leading cause of cancer death in the world and accounts for more than 150,000 deaths annually in the United States (1). Global progress in improving lung cancer outcomes has been exceedingly difficult (2,3). Progress in the specific area of chemoprevention research has also been challenging. Despite a vast at-risk population of current or past users of tobacco products (or perhaps because this population is so vast), it is difficult to assemble an appropriate-sized cohort of at-risk individuals to efficiently conduct a definitive chemoprevention trial (4, 5). In breast cancer, the key dynamic in launching initial chemoprevention research was the utility of tamoxifen in reducing second breast cancers (6,7). Since lung cancer is more frequently lethal than breast cancer, there is no large pool of initial survivors at risk for a second lung cancer. This difficulty in conducting lung cancer chemoprevention trials, though a major detriment to developing more effective lung cancer chemoprevention, is only one of a number of reasons for the lack of significant pharmaceutical industry efforts to develop a lung cancer chemoprevention drug (8).