Grilli Sandro
Dipartimento di Patologia Sperimentale, Università degli Studi, Bologna, Italy.
Ann Ist Super Sanita. 2006;42(2):170-3.
Tamoxifen (TAM) has been used since early '70s as antitumor agent in the adjuvant therapy of breast carcinoma. The aim was (and is) to reduce the incidence of contralateral breast cancer in primary breast cancer bearing patients. Its efficacy was about 30% when estrogen and progesterone receptors were present in the malignant breast tumor and its use in antitumor therapy is, at the present time, rather correct. Viceversa, the employment of TAM in chemoprevention of breast tumor in healthy and/or at-risk women by more than a decade has been contrasting by many scientists and supporting by others. Indeed, TAM produces not only beneficial effects but also detrimental effects (mainly induction of endometrial cancer). According to the Author of this manuscript, TAM would not be used for primary or secondary mammary tumor chemoprevention. For such purposes the right way is to wait for conclusion of ongoing clinical trials on other pure antiestrogenic agents. Indeed, good candidates to act as an antiestrogen both in breast and in endometrial tissue are under validation. In the meanwhile, the scientific dispute goes on.
自20世纪70年代初以来，他莫昔芬（TAM）一直被用作乳腺癌辅助治疗中的抗肿瘤药物。其目的是（过去是，现在也是）降低原发性乳腺癌患者对侧乳腺癌的发病率。当恶性乳腺肿瘤中存在雌激素和孕激素受体时，其疗效约为30%，目前其在抗肿瘤治疗中的应用是相当正确的。相反，十多年来，许多科学家对TAM在健康和/或有风险女性中预防乳腺肿瘤的应用持反对态度，而另一些人则表示支持。事实上，TAM不仅会产生有益影响，还会产生有害影响（主要是诱发子宫内膜癌）。根据本文作者的观点，TAM不应用于原发性或继发性乳腺肿瘤的化学预防。为此，正确的做法是等待其他纯抗雌激素药物正在进行的临床试验得出结论。事实上，在乳腺和子宫内膜组织中均能发挥抗雌激素作用的优秀候选药物正在接受验证。与此同时，科学争论仍在继续。
