Word: tamoxifen
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...postmenopausal women who have been treated for breast cancer, five is a magic number. The standard therapy for tackling the majority of their tumors is surgery to remove the lumps, then the drug tamoxifen for five years to prevent cancer from recurring. After five years, the body becomes resistant to tamoxifen's effects. At that point, women stop taking it, cross their fingers and hope for the best. "There wasn't really anything available for them," explains Dr. Andrew von Eschenbach, director of the National Cancer Institute. "Yet we knew that many women risk recurrences even beyond five years...
...involved in an international study finally gave these women a way to keep fighting their cancer beyond five years. In a study that the New England Journal of Medicine published online, the doctors report that a currently available drug, letrozole (marketed by Novartis as Femara), could pick up where tamoxifen leaves off. In a trial involving more than 5,100 women, those taking letrozole after five years on tamoxifen experienced 43% fewer cancer recurrences than those assigned to the placebo group. The benefit was so great that doctors decided to cut the trial short to give the placebo group...
Breast cancer is a prime example. For more than two decades, women with early-stage, estrogen-sensitive breast cancers have been treated with surgery followed by a combination of tamoxifen and chemotherapy. Adding tamoxifen seemed to make sense, since it blocks estrogen's cancer-promoting effects. It turns out, however, that tamoxifen may act as a spoiler, preventing the chemotherapy agents from entering cancer cells and doing their job. In a paper being presented this week, researchers will report on a finding that should change the way doctors treat patients from now on; after eight years of follow-up exams...
Five years ago, doctors and their patients hailed tamoxifen, which was the first drug approved for reducing the risk of getting breast cancer (rather than just treating it). But tamoxifen is far from perfect. It increases the risk of uterine cancer and potentially fatal blood clots. Raloxifene appears to provoke fewer side effects, but the results from a head-to-head study comparing the two drugs won't be available until...
Meanwhile, researchers are getting better at predicting who is most likely to benefit from which designer estrogen. Raloxifene, it turns out, is most effective for the postmenopausal women who have naturally high levels of estrogen. Other tests suggest that tamoxifen offers little or no benefit to women who carry the BRCA1 mutation, one of two genetic mutations known to cause an inherited form of breast cancer, but it can help lower the risk of breast cancer in women carrying a variation of the gene called BRCA2. For now, women who are taking tamoxifen should continue doing...