SERMs in chemoprevention of breast cancer.
Selective estrogen receptor modulators (SERMs) play a key role in breast cancer chemoprevention. Tamoxifen has been shown to reduce breast cancer incidence by 30-40% in at-risk subjects in large phase III trials. However, toxicity may be a limiting factor. Thus, different strategies are being pursued to improve the risk: benefit ratio of using these compounds in chemoprevention. Firstly, the second generation SERM raloxifene is currently undergoing evaluation in comparison with tamoxifen in a large phase III trial. Also, lower doses of tamoxifen are being assessed in phase II-III trials. In addition, the combination of hormone replacement therapy (HRT) or aromatase inhibitors and tamoxifen at low doses may reduce the risks while retaining the benefits of either agents. Finally, new agents that interfere with the onset of ER-negative breast cancer are being sought for combination chemoprevention since almost a third of breast cancers will not be sensitive to hormonal modulation.
Gasco
Milena
M
Division of Medical and Preventive Oncology, E.O. Ospedali Galliera, 16128 Genoa, Italy.
Argusti
Alessandra
A
Bonanni
Bernardo
B
Decensi
Andrea
A
D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D012176:Retinoids / Q000008:administration & dosage; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*
D016588:Anticarcinogenic Agents; D047072:Aromatase Inhibitors; D012176:Retinoids; D020845:Selective Estrogen Receptor Modulators