Toremifene: an evaluation of its safety profile.
Toremifene has been in clinical use for 8 years for the treatment of advanced hormone-sensitive breast cancer and the adjuvant treatment of early breast cancer. More than 350,000 patient treatment years have accumulated, sufficient to allow evaluation of its longer-term safety profile in comparison with tamoxifen and, where possible, with raloxifene and aromatase inhibitors. We reviewed all preclinical and clinical safety data from 1978 to 2004 and comparative clinical safety data between October 1995 and the end of 2004. Secondary endometrial cancer incidence was lower with toremifene than with tamoxifen and was similar to that with raloxifene. It is speculated that toremifene may unmask existing endometrial tumors rather than induce new events. The risk of stroke, pulmonary embolism, and cataract may be lower with toremifene than with tamoxifen and the risk of pulmonary embolism and deep vein thrombosis lower than with raloxifene. Beneficial estrogen agonistic effects were equivalent to those of tamoxifen regarding bone mineral density and superior regarding lipid profiles.
Harvey
Harold A
HA
Division of Hematology/Oncology, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA. hharvey@psu.edu
Kimura
Morihiko
M
Hajba
Alajos
A
D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000139:chemically induced; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D016889:Endometrial Neoplasms / Q000139:chemically induced; D005260:Female; D006801:Humans; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000473:pathology; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D017312:Toremifene / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D017312:Toremifene