The Breast Cancer Continuum: insights from the tamoxifen trials impact future drug development strategies.
The Breast Cancer Continuum includes women at high risk, as in the Breast Cancer Prevention Trial; those with a history of atypical ductal hyperplasia (ADH) or lobular carcinoma in situ (LCIS); women with ductal carcinoma in situ (DCIS); those with <1 cm invasive disease or node-negative or node-positive disease; and those at risk of developing contralateral breast cancer. Women in all these categories benefit from therapeutic intervention with tamoxifen because each clinical state is associated with a certain probability of having early undiagnosed invasive breast cancer responsive to tamoxifen. This framework, relating these disorders to each other through their 5-year incidence of developing invasive breast cancer, leads to important conclusions relative to pharmaceutical drug development strategies, including chemoprevention investigations.
Lewis
J P
JP
AstraZeneca Pharmaceuticals, Wilmington, Delaware 19850, USA. Jerry.Lewis@astrazeneca.com
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D015195:Drug Design; D005260:Female; D006801:Humans; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen