The Search for Better SERMs Continues
BUFFALO, NY-Breast cancer offers a paradigm for cancer prevention issues. It has been shown that lower exposure to estrogen results in a lower risk of breast cancer. However, a decrease in overall estrogen may pose health risks for women such as increased risk for heart disease. Thus, patients and physicians must evaluate all options available, said Richard M. Elledge, MD, medical director of the Breast Care Center at Baylor College of Medicine-The Methodist Hospital, Houston.
BUFFALO, NYBreast cancer offers a paradigm for cancer prevention issues. It has been shown that lower exposure to estrogen results in a lower risk of breast cancer. However, a decrease in overall estrogen may pose health risks for women such as increased risk for heart disease. Thus, patients and physicians must evaluate all options available, said Richard M. Elledge, MD, medical director of the Breast Care Center at Baylor College of Medicine-The Methodist Hospital, Houston.
Selective estrogen receptor modulators (SERMs) offer a potential method to interrupt the transformation of normal breast tissue into cancer. But the currently available SERMs such as tamoxifen [Nolvadex] do not meet all of our needs. There is still work to be done to create the ideal preventive agent, Dr. Elledge said at the New Horizons in Cancer Prevention Symposium, hosted by Roswell Park Cancer Institute.
An ideal SERM would be antiestrogenic in both the breast and uterus, maintain bone density, decrease cholesterol levels, be estrogenic in the brain, have no effect on clotting, and sustain this profile over time.
The SERM currently approved for prevention, tamoxifen, only meets part of the criteria for an ideal SERM. Its negative effect in the uterus and its inability to remain antiestrogenic after long-term use make it useful for now, but it is not the answer we need, Dr. Elledge said.
Newer SERMs, such as raloxifene (Evista), may be closer to the ideal profile, but only long-term clinical trials such as STAR (Study of Tamoxifen and Raloxifene) will answer this question, he said. There is also a real need for validated biomarkers to better identify effective agents in a faster period of time, he said.
The possibility of side effects limits the general use of SERMs. We need better methods of identifying patients who need to consider the use of preventive SERM therapy; we need to deal with the other obstacles to the widespread use of these drugs; and we need to find a way to get these answers faster so we can help women make the best choice for their care, Dr. Elledge said.
Experts Discuss Differences in Radiotherapy Outcomes in BRCA+ Breast Cancer
October 30th 2023Rebecca M. Shulman, MD, and Zachary Kiss, DO, discuss findings from a study evaluating differences in outcomes with radiotherapy and disease characteristics of patients with breast cancer harboring BRCA mutations compared with those without mutated disease.
FDA Approves Capivasertib Plus Fulvestrant in Advanced HR+, HER2– Breast Cancer
November 16th 2023Patients with locally advanced or metastatic breast cancer that is hormone receptor–positive, HER2-negative breast cancer with 1 or more PIK3CA, AKT1, or PTEN alterations may now receive capivasertib plus fulvestrant.
Oncology On-The-Go Podcast: De-escalating Breast Cancer Treatment
May 8th 2023Rakhshanda Rahman, MD, FRCS, FACS, emphasizes the importance of educating patients and physicians on the potential risks and benefits of new approaches and technologies involved in the de-escalation of breast cancer treatment.
