Keith RL, et al. - Via a double-blind, randomized, phase 2 placebo-controlled trial, researchers determined the impact of oral pioglitazone for lung cancer chemoprevention in high-risk current or former smokers with sputum cytologic atypia or known endobronchial dysplasia. At study entry and after completing 6 months of treatment, bronchoscopy was carried out. Biopsies were histologically graded and an inflammation score was also allocated. The trial collected 92 cases (47 pioglitazone, 45 placebo); 76 completed both bronchoscopies (39 pioglitazone, 37 placebo). For current smokers, baseline dysplasia was significantly worse. At study entry, 64% of subjects had mild or greater dysplasia. Improvement in bronchial dysplasia could not be demonstrated in individuals who took pioglitazone. In this high-risk cohort, pioglitazone did not improve endobronchial histology, but specific lesions exhibited histologic improvement; further study would be required for better characterization of responsive dysplasia.