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July 2003 Inhaled steroids and the prevention of lung cancer
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Vol. 39. Issue 7.
Pages 328 (July 2003)
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Vol. 39. Issue 7.
Pages 328 (July 2003)
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Inhaled steroids and the prevention of lung cancer
Esteroides inhalados y prevención del cáncer de pulmón
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Á. López Encuentraa
a Servicio de Neumología. Hospital Universitario 12 de Octubre. Madrid. Spain.
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To the Editor: For some years, chronic obstructive pulmonary disease (COPD) has been considered a risk factor for the development of lung cancer, independent of smoking1.

Several randomized controlled trials of inhaled steroids in COPD have been published recently2-4. Together, these studies have enrolled 2,683 COPD patients randomly assigned to receive inhaled steroid therapy or not.

At the same time, results from experimental studies have suggested that inhaled steroids may have a protective effect against pulmonary carcinogenesis5,6.

Now that several years have passed since the start of clinical trials, it might be time to seek an answer to this question: is it possible to follow the evolution of these 2683 patients long enough to detect a possible chemopreventive effect?

Bibliography
[1]
Tockman S, Anthonisen NR, Wright EC, Donithan MG..
Airways obstruction and the risk for lung cancer..
Ann Intern Med, 106 (1987), pp. 512-8
Medline
[2]
The Lung Health Study Research Group..
Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease..
N Engl J Med, 343 (2000), pp. 1902-9
http://dx.doi.org/10.1056/NEJM200012283432601 | Medline
[3]
Pauwels RA, Lofdahl CG, Laitinen LA, Schouten JP, Postma DS, Pride NB, et al..
Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. European Respiratory Society Study on Chronic Obstructive Pulmonary Disease..
N Engl J Med, 340 (1999), pp. 1948-53
http://dx.doi.org/10.1056/NEJM199906243402503 | Medline
[4]
Vestbo J, Sorensen T, Lange P, Brix A, Torre P, Viskum K..
Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial..
Lancet, 353 (1999), pp. 1819-23
Medline
[5]
Paolieri F, Battifora M, Riccio AM, Ciprandi G, Scordamaglia A, Morelli C, et al..
Inhibition of adhesion molecules by budesonide on a human epithelial cell line (lung carcinoma)..
Allergy, 52 (1997), pp. 935-43
Medline
[6]
Wattenberg LW, Wiedmann TS, Estensen RD, Zimmerman CL, Galbraith AR, Steele VE, et al..
Chemoprevention of pulmonary carcinogenesis by brief exposures to aerosolized budesonide of beclomethasone dipropionate and by the combination of aerosolized budesonide and dietary myoinositol..
Carcinogenesis, 21 (2000), pp. 179-82
Medline

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