Drug Insight: breast cancer prevention and tissue-targeted hormone replacement therapy

摘要: Selective estrogen-receptor modulators (SERMs) improve survival in women with breast cancer. There is, however, a need for more-effective SERMs and, most importantly, tissue-targeted alternatives to classical hormone replacement therapy while preventing This article describes how combining SERM and dehydroepiandrosterone might prevent uterine cancers, benefiting other tissues affected by the menopause. The first-generation selective estrogen receptor modulator (SERM) tamoxifen has been mainstream Tamoxifen benefits all stages of disease, but its use increases risk cancer thromboembolic events it can only be administered 5 years. Aromatase inhibitors are superior at advanced disease as adjuvants; because they increase fractures, aromatase unlikely used disease. Raloxifene, second-generation SERM, leads, like tamoxifen, approximately 50% fewer cases invasive high women, lower incidence events. Several development tissue specificity, efficacy tolerance. Raloxifene shows protection against vertebral fractures similar bisphosphonates; no significant effect observed on nonvertebral fractures. Many prevention treatment osteoporosis. As metastasizes early cannot cured, is essential. To avoid concerns about traditional therapy, dehydroepiandrosterone—a precursor sex steroid formation—offers hope physiological that, combined would simultaneously