Goldstein S R
New York University School of Medicine, 530 First Avenue Suite 10N, New York, NY 10016, USA.
Eur J Cancer. 2000 Sep;36 Suppl 4:S54-6. doi: 10.1016/s0959-8049(00)00227-6.
In the mid 1980s when tamoxifen was shown to be associated with endometrial neoplasia there was a renewed interest in another SERM compound, raloxifene. Experimental animal data suggested that raloxifene did not stimulate the endometrium as tamoxifen does while having similar anti-oestrogenic effects in breast tissue as tamoxifen. Clinical data has now shown that raloxifene does not stimulate the endometrium in postmenopausal women. It results in no hyperplasia, no increase in endometrium thickness or polyp formation and virtually no proliferation. Further studies are necessary to see if long-term raloxifene use will reduce the risk of endometrial cancer. In studies of raloxifene as treatment for osteoporosis, when viewed as a secondary endpoint there was a significant reduction in risk of new onset breast cancer. Further studies with breast cancer as a primary endpoint are ongoing (the STAR Trial).
20世纪80年代中期，当他莫昔芬被证明与子宫内膜肿瘤相关时，人们对另一种选择性雌激素受体调节剂（SERM）化合物雷洛昔芬重新产生了兴趣。实验动物数据表明，雷洛昔芬不像他莫昔芬那样刺激子宫内膜，而在乳腺组织中具有与他莫昔芬相似的抗雌激素作用。临床数据现已表明，雷洛昔芬不会刺激绝经后妇女的子宫内膜。它不会导致增生、子宫内膜厚度增加或息肉形成，实际上也不会引起增殖。有必要进行进一步研究，以确定长期使用雷洛昔芬是否会降低子宫内膜癌的风险。在雷洛昔芬治疗骨质疏松症的研究中，将新发乳腺癌风险视为次要终点时，风险显著降低。以乳腺癌为主要终点的进一步研究正在进行中（STAR试验）。
