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Nature Clinical Practice Oncology (2008) 5, 628-629
doi:10.1038/ncponc1221  
Received 16 June 2008 | Accepted 17 July 2008 | Published online: 26 August 2008

Concomitant DFMO and sulindac chemoprevention of colorectal adenomas: a major clinical advance

Michael B Sporn* and Waun Ki Hong

Correspondence *Department of Pharmacology, Dartmouth Medical School, Hanover, NH 03755, USA

Email
 michael.b.sporn@dartmouth.edu

In a randomized, placebo-controlled, double-blind clinical trial by Meyskens et al. the combination of difluoromethylornithine and sulindac has been shown to be strikingly effective for prevention of sporadic colorectal adenomas. This concomitant use of two drugs to suppress the progression of preneoplastic lesions represents the first major clinical success of the application of the principle of 'combination chemoprevention'. Neither drug alone has previously had clinical utility at the low doses used in this trial. The combination of the two agents has provided synergistic efficacy in suppression of carcinogenesis, while minimizing any undesirable adverse effects. This study should be the impetus for further clinical investigation of the use of multiple drugs for chemoprevention of cancer.

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