Factors predisposing hormone-dependent tissues to the development of tumors coincide, at least partly, with hormonal-metabolic promoters (like insulin resistance, glucose intolerance, visceral obesity, etc.) of other main non-communicable diseases. This important knowledge poses the question of whether the same approach which is applied for prevention/treatment of a metabolic syndrome and the associated endocrine disorders might also be used in preventive and therapeutic oncology. Whereas an answer to this question remains controversial and is based mainly on experimental evidence, there is accumulating clinical data suggesting a practical significance of such a strategy, even though it is not to be considered as directly cytostatic. Among the many drugs under discussion, three groups of medicines (statins, antidiabetic biguanides, and thiazolidinediones) are the most attractive. The concept of metabolic rehabilitation is proposed and used practically in an adjuvant setting for the correction of the above-mentioned endocrine-metabolic disorders commonly found in cancer patients. The current use and aim of this approach is to improve the survival of patients and limit cancer progression. Nonetheless, it also appears potentially useful as a neoadjuvant therapy as well as a prophylactic treatment earlier in life for specific groups of people with hormone-associated enhanced oncological risk. It seems possible that certain hypolipidemic and antidiabetic medicines with pleiotropic effects might be combined with traditional antisteroid prevention/therapeutic approaches in routine clinical situations as well as for overcoming resistance to standard cancer hormonal therapies including receptor-negative cases. Characteristic at the end of the 20th and at the beginning of the 21st century is an epidemic of diabetes and obesity, which might further increase the incidence of certain cancers. This makes it timely to apply hypolipidemic and antidiabetic drugs (in combination with reasonable dieting, increased physical fitness, and an in-depth knowledge of drug-gene interactions) as an approach warranting further study.

译文

:促激素依赖型组织参与肿瘤发展的因素至少部分与其他主要非传染性疾病的激素代谢启动子(如胰岛素抵抗,葡萄糖耐量,内脏肥胖等)重合。该重要知识提出了一个问题,即用于预防/治疗代谢综合征和相关内分泌疾病的相同方法是否也可以用于预防和治疗肿瘤学。尽管该问题的答案仍是有争议的,并且主要基于实验证据,但是,尽管不被认为直接抑制细胞生长,但越来越多的临床数据表明了该策略的实际意义。在讨论中的许多药物中,三类药物(他汀类药物,抗糖尿病双胍类药物和噻唑烷二酮类药物)最具吸引力。提出了代谢康复的概念,并在辅助环境中实际用于纠正癌症患者中常见的上述内分泌代谢紊乱。该方法的当前用途和目的是提高患者的存活率并限制癌症的进展。尽管如此,它对于某些早期激素相关的增加的肿瘤风险人群,也可能作为新辅助疗法以及生命早期的预防疗法有用。在常规临床情况下以及为了克服对包括受体阴性病例在内的对标准癌症激素疗法的耐药性,某些具有多效性的降血脂药和抗糖尿病药似乎可以与传统的抗类固醇预防/治疗方法结合使用。 20世纪末和21世纪初的特征是糖尿病和肥胖症的流行,这可能会进一步增加某些癌症的发病率。这使得及时应用降血脂和降糖药(与合理的饮食,增加的身体适应性以及对药物基因相互作用的深入了解相结合)作为值得进一步研究的方法。

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