Williams G M, Iatropoulos M J, Djordjevic M V, Kaltenberg O P
American Health Foundation, Division of Pathology and Toxicology, Valhalla, NY 10595.
Carcinogenesis. 1993 Feb;14(2):315-7. doi: 10.1093/carcin/14.2.315.
Tamoxifen (TAM) is used in the treatment of breast cancer and is being given to healthy women to inhibit breast cancer. The present study examines the effects of TAM in female rats exposed for up to one year. Starting at 6 weeks of age, groups of 55-57 female Sprague-Dawley rats were given TAM by gavage daily at 2.8, 11.3 or 45.2 mg/kd body weight/day, for up to 1 year with two recovery segments, 4 weeks of recovery after 6 months of exposure, and 3 months of recovery after 12 months of exposure. Complete necropsies and histopathology were performed. Drug-related mortality was highest in the high TAM group. In the two high dose groups, hepatoproliferative lesions were present in time- and dose-related incidence, severity and multiplicity. In the high dose rats, at 6 months, hepatocellular adenomas and carcinomas were observed in 71 and 29% of rats respectively. With 1 month of recovery, at 7 months the adenomas and carcinomas were increased to 75%. At 12 months the adenomas were present in 50% and carcinomas in 75% of high dose rats. In the mid dose group, liver lesions were not found until 12 months; at this time 50% had adenomas and 10%, carcinomas. After a 3 month recovery period, 45% exhibited adenomas and 45%, carcinomas. Thus, TAM at 45.2 mg/kg/day elicited hepatocellular neoplasia sometime between 3 and 6 months of administration. At 11.3 mg/kg the neoplastic process was evident at 12 months. At 2.8 mg/kg, no hepatoproliferative changes were found. The strong hepatocarcinogenic effect of TAM in rats raises issues bearing on the prophylactic chronic administration to healthy women.
他莫昔芬(TAM)用于治疗乳腺癌,也被用于健康女性以预防乳腺癌。本研究考察了TAM对雌性大鼠长达一年的影响。从6周龄开始,将55 - 57只雌性斯普拉格 - 道利大鼠分为几组,每天经口灌胃给予2.8、11.3或45.2毫克/千克体重/天的TAM,持续1年,设有两个恢复期,暴露6个月后有4周恢复期,暴露12个月后有3个月恢复期。进行了完整的尸检和组织病理学检查。高剂量TAM组的药物相关死亡率最高。在两个高剂量组中,肝增生性病变的发生率、严重程度和病变数量与时间和剂量相关。在高剂量组大鼠中,6个月时,分别有71%和29%的大鼠出现肝细胞腺瘤和癌。经过1个月恢复期,7个月时腺瘤和癌的比例分别增至75%。12个月时,高剂量组大鼠中腺瘤的比例为50%,癌的比例为75%。在中剂量组,直到12个月才发现肝脏病变;此时50%的大鼠有腺瘤,10%有癌。经过3个月恢复期后,45%的大鼠有腺瘤,45%有癌。因此,每天45.2毫克/千克的TAM在给药3至6个月之间的某个时间引发了肝细胞肿瘤形成。每天11.3毫克/千克时,肿瘤形成过程在12个月时明显。每天2.8毫克/千克时,未发现肝增生性变化。TAM对大鼠具有强烈的致癌作用,这引发了关于对健康女性进行预防性长期给药的问题。