© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 21, 1809-1819,
November 3, 1999
© 1999 Oxford University Press
COMMENTARY |
Tamoxifen Prevention of Breast Cancer: an Instance of the Fingerpost
Affiliations of authors: S. M. Lippman, Departments of Clinical Cancer Prevention and Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston; P. H. Brown, Division of Oncology, Department of Medicine, The University of Texas Health Science Center at San Antonio. Present address: P. H. Brown, Breast Center, Department of Medicine, Baylor College of Medicine, Houston.
Correspondence to: Scott M. Lippman, M.D., Department of Clinical Cancer Prevention, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 236, Houston, TX 77030-4095.
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INTRODUCTION |
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Tamoxifen as a chemopreventive agent has produced a fundamental change in the outlook for controlling breast cancer. Tamoxifen in the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 Breast Cancer Prevention Trial (BCPT) achieved a striking 49% reduction in the incidence of invasive breast disease in women at increased risk of breast cancer (1). With this finding, the Food and Drug Administration (FDA) approved tamoxifen for risk reduction in this setting, marking the historic first FDA approval of any agent for cancer risk reduction. The BCPT finding and FDA approval have created a paradigm shift toward pharmacologic preventive approaches (i.e., chemoprevention) for controlling breast cancer.
A major portion of this commentary is devoted to highlights and related issues of the course
of tamoxifen's recent history in breast cancer prevention research, which has been
remarkable. In April 1998, the National Cancer Institute (NCI) and NSABP unblinded the BCPT
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LITERATURE SEARCH METHODS |
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CLINICAL TRIALS |
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Overview
Adjuvant Trials—Contralateral Breast Cancer Risk Reduction
Breast Cancer Prevention Trial
DCIS—NSABP B-24
European Tamoxifen Breast Cancer Prevention Trials
Unresolved Tamoxifen Prevention Issues
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RALOXIFENE VERSUS TAMOXIFEN IN BREAST CANCER PREVENTION |
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MECHANISTIC/MOLECULAR TARGETING PARADIGM: BREAST CANCER CHEMOPREVENTION |
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Tamoxifen/SERM Development
ER-Dependent and ER-Independent New Agent Development
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CONCLUSION |
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NOTES |
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REFERENCES |
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