托瑞米芬作为乳腺癌患者辅助性他莫昔芬的替代药物。
Toremifene as a substitute for adjuvant tamoxifen in breast cancer patients.
作者信息
Bertelli G, Queirolo P, Vecchio S, Angiolini C, Bergaglio M, Del Mastro L, Signorini A, Valenzano M, Venturini M
机构信息
Medical Oncology Division and University, National Cancer Institute, Genova, Italy.
出版信息
Anticancer Res. 2000 Sep-Oct;20(5C):3659-61.
BACKGROUND
Toremifene is a new antiestrogen, which in nonclinical studies appears less carcinogenic than tamoxifen. Clinical trials of adjuvant toremifene vs. tamoxifen in breast cancer patients are ongoing. This study aimed to evaluate the short-term effects of changing from adjuvant tamoxifen to toremifene.
PATIENTS AND METHODS
Twenty postmenopausal breast cancer patients receiving adjuvant tamoxifen, 20 mg/day, were switched to toremifene 60 mg/day. The effects on the uterus were evaluated prospectively by transvaginal ultrasound; tolerability was assessed clinically.
RESULTS
In 14 patients who had uterine abnormalities (endometrial thickening or polyps) under tamoxifen, no significant changes occurred during a median of 18 months (range 7-24) of toremifene treatment. Out of six patients who had entered the study due to intolerance to tamoxifen, however, 3 tolerated toremifene well.
CONCLUSION
Toremifene does not modify previous uterine changes induced by tamoxifen. For some patients who do not tolerate tamoxifen, however, switching to toremifene may allow the continuation of adjuvant antiestrogenic therapy.
背景
托瑞米芬是一种新型抗雌激素药物，在非临床研究中显示出比他莫昔芬致癌性更低。针对乳腺癌患者的辅助性托瑞米芬与他莫昔芬的临床试验正在进行中。本研究旨在评估从辅助性他莫昔芬转换为托瑞米芬的短期效果。
患者与方法
20名接受辅助性他莫昔芬治疗（每天20毫克）的绝经后乳腺癌患者被转换为每天60毫克的托瑞米芬治疗。通过经阴道超声前瞻性评估对子宫的影响；临床评估耐受性。
结果
在14名他莫昔芬治疗期间存在子宫异常（子宫内膜增厚或息肉）的患者中，托瑞米芬治疗中位18个月（范围7 - 24个月）期间未发生显著变化。然而，在因对他莫昔芬不耐受而进入研究的6名患者中，有3名对托瑞米芬耐受性良好。
结论
托瑞米芬不会改变他莫昔芬先前引起的子宫变化。然而，对于一些不耐受他莫昔芬的患者，转换为托瑞米芬可能允许继续进行辅助性抗雌激素治疗。
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