Polyphenolic phytochemicals versus non-steroidal anti-inflammatory drugs: which are better cancer chemopreventive agents?

Non steroidal antiinflammatory drugs (NSAIDs) delay the onset of cancer in rodent models of colorectal carcinogenesis. Clinical trials suggest that they can interfere with preneoplasia in humans; thus they may be chemopreventive agents in humans. As NSAIDs posses unwanted side effects, efforts are being invested in the identification of alternative agents with comparable chemopreventive efficacy but without the toxicity of NSAIDs. Polyphenolic phytochemicals such as curcumin and resveratrol are promising candidates. Like NSAIDs they suppress carcinogenesis in the ApcMin+ mouse model. Clinical pilot studies of curcumin show that it is safe at doses of up to 3.6g daily, and that the levels of curcumin which can be achieved in the gastrointestinal tract exert pharmacological activity. More clinical evaluation will help establish whether polyphenolic phytochemicals are indeed safe and efficacious alternatives to NSAIDs.