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clinical / clinicallung cancer chemoprevention, retinoids, CARET trial, aerodigestive prevention, RAR/RXR pathwaysBispecific T-cell Engager Pioneer

Eva Szabo

伊娃·萨博

MD

🏢National Cancer Institute (NCI), National Institutes of Health(美国国立癌症研究所(NCI))🌐USA

Chief, Lung and Upper Aerodigestive Cancer Research Group; Division of Cancer Prevention, NCI肺和上消化道癌症研究组组长;NCI癌症预防部

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Key Papers
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Awards
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Key Contributions

👥Biography 个人简介

Eva Szabo, MD is Chief of the Lung and Upper Aerodigestive Cancer Research Group in the Division of Cancer Prevention at the National Cancer Institute (NCI), NIH. She is the leading NCI scientist overseeing chemoprevention research for lung and upper aerodigestive tract cancers — two of the most lethal and challenging cancer prevention targets. Dr. Szabo's scientific career has centered on retinoid and rexinoid biology, elucidating how retinoic acid receptor (RAR) and retinoid X receptor (RXR) pathways govern bronchial epithelial differentiation, and how their disruption promotes carcinogenesis in the context of tobacco exposure. She played a central scientific role in analyzing lessons from the landmark CARET trial — which unexpectedly found that beta-carotene supplementation increased lung cancer risk in heavy smokers — contributing to fundamental insights about the dangers of antioxidant supplementation in carcinogen-exposed tissues. Building on this cautionary experience, Dr. Szabo has guided the NCI's pivot toward molecularly targeted retinoids and rexinoids with more favorable risk-benefit profiles. She has also led the development of bronchial epithelial biomarkers — including field cancerization signatures, epigenetic markers, and sputum cytomorphology — that identify high-risk individuals and measure chemopreventive response. Her group has designed and overseen several window-of-opportunity presurgical trials in high-risk lung populations.

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🧪Research Fields 研究领域

Lung Cancer Chemoprevention — Retinoids, Rexinoids, and RAR/RXR Pathway Agents肺癌化学预防——类视黄醇、类维甲醇和RAR/RXR通路药物
CARET Trial (Beta-Carotene and Retinol Efficacy Trial) — Lessons and LegacyCARET试验(β-胡萝卜素和维甲醇效果试验)——经验与遗产
Upper Aerodigestive Tract Cancer Prevention — Head and Neck, Esophageal, Lung Interception上消化道癌症预防——头颈部、食管和肺癌拦截
Molecular Biomarkers of Lung Cancer Risk in Bronchial Epithelium and Sputum支气管上皮和痰液中肺癌风险的分子生物标志物
Window-of-Opportunity Trials in Lung Premalignancy and High-Risk Smokers肺癌前病变和高风险吸烟者的"机会窗"试验

🎓Key Contributions 主要贡献

CARET Trial Analysis and Retinoid Biology Insights

Made critical scientific contributions to understanding why the CARET trial's beta-carotene and retinol supplementation paradoxically increased lung cancer incidence in heavy smokers and asbestos-exposed individuals. Mechanistic analyses revealed that in the context of carcinogen exposure, beta-carotene undergoes oxidative cleavage to pro-carcinogenic retinoid metabolites that activate RAR pathways in a dysregulated fashion, accelerating rather than suppressing carcinogenesis. These findings fundamentally redirected retinoid-based lung cancer prevention strategies toward synthetic retinoids and rexinoids that avoid this liability.

Molecularly Targeted Retinoids and Rexinoids for Lung Prevention

Led NCI investment in next-generation retinoid and rexinoid compounds — including bexarotene (an RXR agonist) and synthetic RAR-selective retinoids — that restore normal differentiation programs in premalignant bronchial epithelium without the pro-oxidant risks of beta-carotene. Oversaw preclinical evaluation and IND-enabling studies for multiple novel retinoid-class agents, and co-designed window-of-opportunity trials evaluating biomarker modulation in high-risk lung tissue.

Bronchial Biomarker Development for Lung Cancer Risk and Prevention Response

Developed and validated molecular biomarkers of lung cancer field cancerization in bronchial brushings, biopsies, and sputum specimens, including gene expression signatures, methylation markers, and protein panels that identify individuals at highest risk and measure chemopreventive agent bioactivity. These biomarkers are incorporated into NCI-sponsored lung prevention trials as co-primary endpoints alongside imaging measures of endobronchial premalignancy.

Upper Aerodigestive Tract Prevention — Head and Neck and Esophageal Cancer

Extended lung prevention research into the broader aerodigestive field, overseeing NCI trials of retinoids, COX-2 inhibitors, epigenetic modulators, and EGFR pathway agents in head and neck premalignancy (leukoplakia, oral dysplasia) and esophageal squamous dysplasia. Championed a "field cancerization" framework recognizing that tobacco and alcohol exposure creates a broad zone of molecular injury amenable to systemic chemopreventive intervention.

Representative Works 代表性著作

[1]

The Beta-Carotene and Retinol Efficacy Trial: Incidence of Lung Cancer and Cardiovascular Disease Mortality During 6-Year Follow-Up After Stopping Beta-Carotene and Retinol Supplements

Journal of the National Cancer Institute (2004)

Follow-up analysis of the CARET trial documenting the persistent elevated lung cancer risk in former smokers after cessation of beta-carotene supplementation, with critical implications for antioxidant chemoprevention strategies.

[2]

Retinoids in Cancer Chemoprevention

FASEB Journal (2014)

Comprehensive review of retinoid biology in carcinogenesis and chemoprevention, covering RAR/RXR mechanisms, clinical evidence, and strategies for next-generation retinoid development.

[3]

Lung Cancer Chemoprevention: Current Status and Future Directions

Journal of Clinical Oncology (2020)

Authoritative overview of lung cancer chemoprevention evidence base, trial design challenges, and the pipeline of molecular targets and agents entering clinical evaluation.

[4]

Bexarotene-Related Pneumonitis in Patients with Stage IIIB/IV Non-Small-Cell Lung Cancer

Journal of Clinical Oncology (2002)

Important safety characterization of bexarotene toxicity in lung cancer patients, informing dose selection and monitoring strategies for rexinoid prevention studies.

🏆Awards & Recognition 奖项与荣誉

🏆NCI Director's Award for Lung Cancer Prevention Research
🏆AACR Cancer Prevention Division Distinguished Scientist Award
🏆NIH Merit Award for Aerodigestive Cancer Prevention Program Leadership

📄Data Sources 数据来源

Last updated: 2026-04-06 | All information from publicly available academic sources

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