Emerging concepts in targeting the polyamine metabolic pathway in epithelial cancer chemoprevention and chemotherapy.

The polyamines are important molecules governing cell proliferation, survival and apoptosis. Consistent with their elevated levels in cancer, they have been shown to mediate tumor promotion and progression. Cellular and tissue polyamine pools and metabolic flux are regulated by a number of processes. Neoplastic transformation is accompanied with an increase in biosynthesis, decreased catabolism and elevated uptake of exogenous polyamines. Effective strategies for cancer chemoprevention and chemotherapy, targeting the polyamine metabolic pathway will likely require a combination of agents acting at multiple sites of this pathway. Genetic variability affecting expression of the ornithine decarboxylase gene suggests an association between ODC expression and cancer risk, and prediction of response to treatment in certain epithelial cancers.