A Review of the Prevention of Invasive Breast Cancer with Raloxifene in Postmenopausal Women

2009 ◽  
Vol 1 ◽  
pp. CMT.S2063
Author(s):  
Belisario A. Arango ◽  
Aurelio B. Castrellon ◽  
Edgardo S. Santos ◽  
Stefan Gluck
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Postmenopausal Women ◽  
Invasive Breast Cancer ◽  
The United States ◽  
Estrogen Receptor Modulators ◽  
Significant Difference ◽  
Prevention Of Osteoporosis ◽  
Receptor Modulators ◽  
Star Trial

Breast cancer remains the second leading cause of malignancy-related death in women in the United States, regardless of advances in novel therapeutic agents. High priority should be emphasized in research aimed at the study of pharmacological and natural compounds that may potentially prevent the development of breast cancer in susceptible patients. Among the known selective estrogen receptor modulators with proven chemopreventive effects, raloxifene has been studied in a number of clinical trials evaluating this drug for the prevention of osteoporosis and coronary heart disease. The MORE and CORE trials had as a primary end point the efficacy of raloxifene in the treatment of women with osteoporosis. These studies showed that raloxifene reduced the risk of invasive breast cancer in postmenopausal women. However, the STAR trial showed no significant difference between raloxifene and tamoxifen recipients in the incidence of invasive breast cancer in postmenopausal women at high risk of invasive breast cancer. This review focuses on the chemopreventive properties of raloxifene and the clinical trials that have proven its efficacy as a chemopreventive agent in invasive breast cancer.

scholarly journals Role of Hormones in Cancer Prevention

2014 ◽  
pp. 34-40 ◽  
Author(s):  
Victor G. Vogel
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitor ◽  
Postmenopausal Women ◽  
Invasive Breast Cancer ◽  
White Women ◽  
Risk Index ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Increased Risk

Risk for breast cancer can be easily and rapidly assessed using validated, quantitative models. Multiple randomized studies show that the selective estrogen response modifiers (SERMs) tamoxifen and raloxifene can safely reduce the risk of invasive breast cancer in both pre- and postmenopausal women. Treatment resulted in a 38% reduction in breast cancer incidence, and 42 women would need to be treated to prevent one breast cancer event in the first 10 years of follow-up. Reduction was larger in the first 5 years of follow-up than in years 5 to 10, but no studies treated patients for longer than 5 years. Thromboembolic events were significantly increased with all SERMs, whereas vertebral fractures were reduced. Tamoxifen provides net benefit to all premenopausal women who are at increased risk, whereas raloxifene reduces risk nearly as much in postmenopausal women and offers increased safety. Both tamoxifen and raloxifene reduce the incidence of in situ cancers. Lasofoxifene reduced the risk of breast cancer by 79% in postmenopausal women with osteoporosis. The MAP3 trial showed a 65% reduction in the annual incidence of invasive breast cancer in postmenopausal women who were at moderately increased risk for breast cancer who took the aromatase inhibitor exemestane. The IBIS-II trial showed a 53% reduction in the risk of invasive breast cancer in postmenopausal women aged 40 to 70 who took the aromatase inhibitor anastrozole. Of the 50 million white women in the United States aged 35 to 79, 2.4 million would have a positive benefit/risk index for chemoprevention.

The Role of Selective Estrogen Receptor Modulators in the Prevention of Breast Cancer: Comparison of the Clinical Trials

2004 ◽  
Vol 9 (2) ◽  
pp. 116-125 ◽  
Author(s):  
Silvana Martino ◽  
Joseph Costantino ◽  
Michelle McNabb ◽  
John Mershon ◽  
Katherine Bryant ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Estrogen Receptor ◽  
Selective Estrogen Receptor Modulators ◽  
Estrogen Receptor Modulators ◽  
Receptor Modulators ◽  
Prevention Of Breast Cancer

Selective estrogen receptor modulators (SERMs) in postmenopausal women's health

2000 ◽  
Vol 8 (3) ◽  
pp. 215-228 ◽  
Author(s):  
DW Purdie ◽  
P Albertazzi
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement ◽  
Term Treatment ◽  
Age Group ◽  
Estrogen Receptor Modulators ◽  
Long Term Treatment ◽  
Prevention Of Osteoporosis ◽  
The Uk ◽  
Receptor Modulators

Over the past ten years mortality for breast cancer in the UK has been falling. The decrement has been more substantial in the 20 to 69 age group, which has seen a 22% decrease, while in the 70 to 79 age group the decrease has been milder at 12%. The incidence of the disease, however, is increasing and many women have a relative or friend with a disease that they perceive to be extremely mutilating. Fear of breast cancer is such among women that it is mistakenly viewed as the most common cause of death in females. Postmenopausal hormone replacement therapy (HRT) has many benefits and is particularly effective in the prevention of osteoporosis. But, to obtain this effect, HRT has to be continued for many years and long-term treatment has been shown to slightly increase the risk of breast cancer. This fact forcefully stimulated the imagination of both press and public alike.

Menopause and psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S46-S46
Author(s):  
J. Usall ◽  
E. Huerta-Ramos
Keyword(s):  
Clinical Trials ◽  
Postmenopausal Women ◽  
Negative Symptoms ◽  
Late Onset ◽  
Preventive Treatment ◽  
Estrogen Receptor Modulators ◽  
Competing Interest ◽  
Receptor Modulators ◽  
Better Than

There has been little research into the effects of menopause on symptoms, social and cognitive functioning in women with schizophrenia, and the results are controversial. The most replicated finding is that late-onset schizophrenia is more prevalent in women than in men and that this fact appears to be related to the diminution of estrogen levels during menopause.Estrogens have a known protective effect on CNS. Animal research has shown that estrogen has a modulating effect on the dopaminergic, glutamatergic and serotonergic systems.There are concerns about long-term use of sexual hormone therapy in postmenopausal women with regard to breast cancer risk, and the use of the selective estrogen receptor modulators (SERMS's) can be a better option.Raloxifene is a SERM that is used in the preventive treatment of postmenopausal osteoporosis and has no effect in the breast and uterus. A number of studies seem to indicate that raloxifene acts on brain dopamine and serotonin systems in a similar way to conjugated estrogens.In this presentation, I will show the results of some clinical trials that have studied the efficacy of raloxifene as a coadjuvant treatment of patients with schizophrenia. Our team has done two clinical trials that studied the efficacy of 60 mg of raloxifene for the treatment of negative symptoms in postmenopausal women with schizophrenia. Our results showed that raloxifene improved the negative symptoms better than placebo. We concluded that raloxifene seems to be a promising option to treat some patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Phase III, Double-Blind, Controlled Trial of Atamestane Plus Toremifene Compared With Letrozole in Postmenopausal Women With Advanced Receptor-Positive Breast Cancer

2007 ◽  
Vol 25 (31) ◽  
pp. 4961-4966 ◽  
Author(s):  
Paul Goss ◽  
Igor N. Bondarenko ◽  
Georgiy N. Manikhas ◽  
Kelly B. Pendergrass ◽  
Wilson H. Miller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Controlled Trial ◽  
Objective Response ◽  
The United States ◽  
Phase Iii ◽  
Double Blind ◽  
Estrogen Receptor Modulators ◽  
Hazard Ratios ◽  
Baseline Characteristics ◽  
Receptor Modulators

Purpose To compare time to progression (TTP) with a steroidal aromatase inhibitor (AI) atamestane (ATA) combined with toremifene (TOR; complete estrogen blockade) versus letrozole (LET) in receptor-positive advanced breast cancer (ABC). Patients and Methods Eligibility included postmenopausal receptor-positive ABC and adjuvant hormonal therapy completed more than 12 months prior to study entry. Participants received daily ATA 500 mg with TOR 60 mg (ATA + TOR), or letrozole 2.5 mg (LET). The primary end point was TTP, whereas secondary objectives included objective response (OR), overall survival (OS), and time to treatment failure (TTF). The study had 80% power to detect a 25% increase in TTP assuming a TTP of 9.4 months in the LET population. Results A total of 865 patients were randomly assigned (434 to ATA + TOR and 431 to LET) in 60 centers in the United States, Canada, Russia, and Ukraine. Baseline characteristics were balanced. Median TTP was identical in the two arms at 11.2 months (P < .92). Median TTF was similar at 9.24 months (ATA + TOR) versus 10.44 months (LET). The hazard ratios (LET/ATA + TOR) were 1.00 (95% CI, 0.92 to 1.08) for TTP, 0.99 (95% CI, 0.92 to 1.06) for TTF, and 0.98 (95% CI, 0.87 to 1.11) for OS. OR occurred in 30% of patients receiving ATA + TOR and in 36% of patients receiving LET (P < .1). Adverse events (AEs) were similar for patients receiving ATA + TOR versus LET, and serious AEs were 10% v 11%, respectively. Conclusion TTP for patients receiving ATA + TOR was identical to that for patients receiving LET, representing the first endocrine therapy comparable to LET in ABC. Unlike in the Anastrozole, Tamoxifen, and Combined trial, addition of an antiestrogen did not decrease efficacy of the AI. Future studies of AIs in combination with more effective selective estrogen receptor modulators or selective receptor downregulators is warranted.

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