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

Fernand Labrie1

  • 1Molecular Endocrinology and Oncology Research Center, Laval University Hospital Research Center (CRCHUL), Quebec City, Quebec, Canada. fernand.labrie@crchul.ulaval.ca

Nature Clinical Practice. Endocrinology & Metabolism
|July 24, 2007
PubMed

Insights

Selective estrogen receptor modulators (SERMs) like tamoxifen and raloxifene show promise in breast cancer prevention. New SERMs and dehydroepiandrosterone may offer simultaneous prevention of breast and uterine cancers.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Tamoxifen, a first-generation selective estrogen receptor modulator (SERM), is a standard breast cancer hormone therapy but has risks like uterine cancer and thromboembolic events.
  • Aromatase inhibitors are effective in advanced disease but increase fracture risk, limiting their use in prevention.
  • Raloxifene, a second-generation SERM, reduces invasive breast cancer in high-risk women with fewer thromboembolic events and protects against vertebral fractures.

Purpose of the Study:

  • To review the role of SERMs in breast cancer prevention and osteoporosis treatment.
  • To explore the potential of novel SERMs and dehydroepiandrosterone for combined breast and uterine cancer prevention.

Main Methods:

  • Literature review of SERMs, including tamoxifen and raloxifene.
  • Discussion of emerging SERMs and dehydroepiandrosterone for hormone replacement therapy.

Main Results:

  • Tamoxifen and raloxifene significantly reduce invasive breast cancer incidence in high-risk women.
  • Raloxifene offers protection against vertebral fractures, similar to bisphosphonates.
  • Several SERMs are under development for improved efficacy and safety in cancer prevention and osteoporosis.

Conclusions:

  • SERMs are crucial for breast cancer prevention, with ongoing development for better tissue specificity and reduced side effects.
  • Dehydroepiandrosterone combined with SERMs presents a potential strategy for simultaneous prevention of breast and uterine cancers, avoiding traditional hormone replacement therapy risks.

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