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Tamoxifen, sold under the brand name Nolvadex among others, is a selective estrogen receptor modulator used to prevent breast cancer in women and men. [13] It is also being studied for other types of cancer. [13] It has been used for Albright syndrome. [14] Tamoxifen is typically taken daily by mouth for five years for breast cancer. [14]
Low-dose chemotherapy is being studied/used in the treatment of cancer to avoid the side effects of conventional chemotherapy. Historically, oncologists have used the highest possible dose that the body can tolerate in order to kill as many cancer cells as possible. [1] After high-dose treatments, the body reacts, sometimes quite severely.
The 2002 USPSTF guidelines were based on studies of SERMs from the MORE, BCPT P-1, and Italian trials. [67] In the MORE trial, the relative risk reduction for raloxifene was 76%. [68] The P-1 preventative study demonstrated that tamoxifen can prevent breast cancer in high-risk individuals.
Tamoxifen is a pure antiestrogenic trans-isomer and has differential actions at estrogen target tissues throughout the body. Tamoxifen is selectively antiestrogenic in the breast but estrogen-like in bones and endometrial cancer. [24] Tamoxifen undergo phase I metabolism in the liver by microsomal cytochrome P450 (CYP) enzymes.
Jordan, V.C. A current view of tamoxifen for the treatment and prevention of breast cancer (Gaddum Memorial Lecture)" British Journal of Pharmacology 110:507-517, 1993. (257 citations as of May 26, 2021). Jordan, V.C. and Morrow, M.M. Tamoxifen, raloxifene and the prevention of breast cancer. Endocrine Reviews 20:253-278, 1999.
One of the largest breast cancer prevention studies ever, [2] it included 22,000 women in 400 medical centers in the United States and Canada. [3] [4] [5]The study concluded that raloxifene caused fewer side-effects and less endometrial cancer than tamoxifen.
Maintenance chemotherapy is a repeated low-dose treatment to prolong remission. [5] [6]: 55–59 Salvage chemotherapy or palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. For these regimens, in general, a better toxicity profile is expected. [6]: 55–59
N-Desmethyltamoxifen (developmental code name ICI-55,548) is a major metabolite of tamoxifen, a selective estrogen receptor modulator (SERM). [1] [2] N-Desmethyltamoxifen is further metabolized into endoxifen (4-hydroxy-N-desmethyltamoxifen), which is thought to be the major active form of tamoxifen in the body.