Hasmann M, Rattel B, Löser R
Department of Pharmacology and Toxicology, Klinge Pharma GmbH, Munich, Germany.
Cancer Lett. 1994 Sep 15;84(2):101-16. doi: 10.1016/0304-3835(94)90364-6.
The new antiestrogen Droloxifene has a 10-60-fold higher binding affinity to the estrogen receptor (ER) compared to the related compound Tamoxifen. A similar relationship was found in growth inhibition studies which showed that Droloxifene inhibited the different ER positive human breast cancer cells more effectively than Tamoxifen, predominantly in drug concentrations which are found in humans during therapy. As another consequence of the high stability of the complex formed by Droloxifene binding to the ER, intermittent exposures with clinically relevant concentrations of Droloxifene brought about effective growth inhibition of human ER positive tumor cells even after short-term application. Droloxifene was found, like Tamoxifen, to block human breast cancer cells in G1-phase of the cell cycle. Moreover, cell-cycle data confirmed the superior growth-inhibiting potency of Droloxifene compared to Tamoxifen. Droloxifene was also found to effectively induce expression of the negative growth factor TGF-beta, to inhibit IGF-I stimulated cell growth and to prevent estrogen-stimulated proto-oncogene c-myc expression. Unlike Tamoxifen, Droloxifene is a potent inhibitor of protein biosynthesis in ER-positive breast cancer cells at physiologically relevant concentrations. Lower estrogenic and higher antiestrogenic effects on immature rat uterus indicate a higher therapeutic index for Droloxifene compared to Tamoxifen. In vivo, Droloxifene displayed increased growth inhibition of different tumors of animal (R3230AC and 13762) and human origin (T61). Furthermore, it was found that the two structurally similar drugs differ in their toxicologic characteristics in the following important respects: Droloxifene is devoid of any in vivo or in vitro carcinogenic or mutagenic effects, whereas Tamoxifen causes liver tumors in rats, induces DNA adduct formation in rats and hamsters and shows transforming activity in SHE-cells (Syrian hamster embryo fibroblasts). Considerably less toxicity and a lower level of intrinsic estrogenicity was observed even after maximum long-term exposure of different animal species to Droloxifene, in comparison with Tamoxifen. Therefore, it can be assumed that Droloxifene may represent an important step forward in the treatment of mammary carcinomas in women through its better tolerability and increased efficacy compared with Tamoxifen. For long-term adjuvant or preventive treatment of breast cancer, Droloxifene may well be the safer choice.
新型抗雌激素药物屈洛昔芬与相关化合物他莫昔芬相比,对雌激素受体(ER)的结合亲和力高10至60倍。在生长抑制研究中也发现了类似的关系,该研究表明,屈洛昔芬比他莫昔芬更有效地抑制不同的ER阳性人乳腺癌细胞,主要是在治疗期间人体中发现的药物浓度下。屈洛昔芬与ER结合形成的复合物具有高稳定性,另一个结果是,即使短期应用临床相关浓度的屈洛昔芬进行间歇性暴露,也能有效抑制人ER阳性肿瘤细胞的生长。与他莫昔芬一样,屈洛昔芬可将人乳腺癌细胞阻滞在细胞周期的G1期。此外,细胞周期数据证实了屈洛昔芬比他莫昔芬具有更强的生长抑制能力。还发现屈洛昔芬能有效诱导负生长因子TGF-β的表达,抑制IGF-I刺激的细胞生长,并阻止雌激素刺激的原癌基因c-myc的表达。与他莫昔芬不同,屈洛昔芬在生理相关浓度下是ER阳性乳腺癌细胞中蛋白质生物合成的有效抑制剂。对未成熟大鼠子宫的雌激素作用较低且抗雌激素作用较高,表明屈洛昔芬的治疗指数高于他莫昔芬。在体内,屈洛昔芬对动物(R3230AC和13762)和人类来源(T61)的不同肿瘤表现出更强的生长抑制作用。此外,发现这两种结构相似的药物在以下重要方面的毒理学特性有所不同:屈洛昔芬在体内或体外均无致癌或致突变作用,而他莫昔芬可导致大鼠肝肿瘤,在大鼠和仓鼠中诱导DNA加合物形成,并在SHE细胞(叙利亚仓鼠胚胎成纤维细胞)中显示转化活性。与他莫昔芬相比,即使不同动物物种长期最大剂量暴露于屈洛昔芬后,其毒性也明显更低,内在雌激素活性水平也更低。因此,可以认为屈洛昔芬与他莫昔芬相比,耐受性更好且疗效更高,可能是女性乳腺癌治疗的重要进展。对于乳腺癌的长期辅助或预防性治疗,屈洛昔芬很可能是更安全的选择。