Mitigating the risk of radiation-induced cancers: limitations and paradigms in drug development

The United States radiation medical countermeasures (MCM) programme for radiological and nuclear incidents has been focusing on developing mitigators for the acute radiation syndrome (ARS) and delayed effects of acute radiation exposure (DEARE), and biodosimetry technologies to provide radiation dos...

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Veröffentlicht in:Journal of radiological protection 2014-06, Vol.34 (2), p.R25-R52
Hauptverfasser: Yoo, Stephen S, Jorgensen, Timothy J, Kennedy, Ann R, Boice Jr, John D, Shapiro, Alla, Hu, Tom C-C, Moyer, Brian R, Grace, Marcy B, Kelloff, Gary J, Fenech, Michael, Prasanna, Pataje G S, Coleman, C Norman
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Sprache:eng
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Zusammenfassung:The United States radiation medical countermeasures (MCM) programme for radiological and nuclear incidents has been focusing on developing mitigators for the acute radiation syndrome (ARS) and delayed effects of acute radiation exposure (DEARE), and biodosimetry technologies to provide radiation dose assessments for guiding treatment. Because a nuclear accident or terrorist incident could potentially expose a large number of people to low to moderate doses of ionising radiation, and thus increase their excess lifetime cancer risk, there is an interest in developing mitigators for this purpose. This article discusses the current status, issues, and challenges regarding development of mitigators against radiation-induced cancers. The challenges of developing mitigators for ARS include: the long latency between exposure and cancer manifestation, limitations of animal models, potential side effects of the mitigator itself, potential need for long-term use, the complexity of human trials to demonstrate effectiveness, and statistical power constraints for measuring health risks (and reduction of health risks after mitigation) following relatively low radiation doses (
ISSN:0952-4746
1361-6498
DOI:10.1088/0952-4746/34/2/R25