The Pharmaceutical Journal
Vol 270 No 7234 p143
1 February 2003

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The Lancet (www.thelancet.com)

More tamoxifen prevention data

More evidence "now clearly shows that tamoxifen can reduce the risk of ER [oestrogen receptor] positive breast cancer". The findings come from an analysis of 14 trials of breast cancer prevention involving over 40,000 women, including five trials with tamoxifen or raloxifene.

The results follow data reported in The Journal last week (January 25, p104) supporting use of tamoxifen for prevention of breast cancer in high risk women and show that tamoxifen reduced the incidence of breast cancer by 38 per cent in women at high risk. Women on either tamoxifen or raloxifene had, however, a two-fold increased risk of a thromboembolic event and a 2.4 relative risk of developing endometrial cancer.

The researchers say that the next challenge is to minimise the side effects of tamoxifen so that it can be used as a frontline preventive drug for breast cancer. Professor Jack Cuzick, senior researcher, Cancer Research UK, and lead author of the review, said: "It may be possible to reduce side effects of tamoxifen by using a lower dose or adding low dose aspirin. Carefully selecting women to exclude those already at risk of blood clotting disorders or endometrial cancer may also be a way of making the use of tamoxifen more viable" (Lancet 2003;361:296).