TY - JOUR
T1 - Preventive therapy for breast cancer
T2 - A consensus statement
AU - Cuzick, Jack
AU - DeCensi, Andrea
AU - Arun, Banu
AU - Brown, Powel H.
AU - Castiglione, Monica
AU - Dunn, Barbara
AU - Forbes, John F.
AU - Glaus, Agnes
AU - Howell, Anthony
AU - von Minckwitz, Gunter
AU - Vogel, Victor
AU - Zwierzina, Heinz
N1 - Funding Information:
JC has received institutional funding and honoraria from AstraZeneca. BA has received funding from the National Cancer Institute and AstraZeneca. JFF has received honoraria from AstraZeneca. AH has received honoraria from AstraZeneca and Novartis. GvM has received institutional funding from AstraZeneca. VV has received consultancy fees from AstraZeneca and Eli Lilly. The other authors declare that they have no conflicts of interest.
PY - 2011/5
Y1 - 2011/5
N2 - In March, 2010, a group of breast cancer experts met to develop a consensus statement on breast cancer prevention, with a focus on medical and therapeutic interventions. We present the conclusions in this Review. First we agreed that the term chemoprevention is inappropriate and suggested that the term preventive therapy better represents this feature of management. Two selective oestrogen-receptor modulators-tamoxifen and raloxifene-are so far the only medical options approved by the US Food and Drug Administration for preventive therapy. Of these tamoxifen has greater efficacy and can be used in premenopausal women, but raloxifene has fewer side-effects. Two newer drugs in this class, lasofoxifene and arzoxifene, also show efficacy and possibly a better overall risk-benefit profile, but need further assessment. Aromatase inhibitors might be more efficacious, and results of prevention trials are eagerly awaited. Newer agents, notably bisphosphonates and metformin, have shown promise in observational studies and need to be assessed in randomised prevention trials. Other agents, such as aspirin, other non-steroidal anti-inflammatory drugs, COX-2 inhibitors, retinoids, rexinoids, and dietary components have limited effects or are in the early phases of investigation. New contralateral tumours in women with breast cancer might be generally useful as a model for prevention, as has been seen for tamoxifen. If valid such a model would facilitate the design of simpler, cheaper, and better-focused trials for assessing new agents.
AB - In March, 2010, a group of breast cancer experts met to develop a consensus statement on breast cancer prevention, with a focus on medical and therapeutic interventions. We present the conclusions in this Review. First we agreed that the term chemoprevention is inappropriate and suggested that the term preventive therapy better represents this feature of management. Two selective oestrogen-receptor modulators-tamoxifen and raloxifene-are so far the only medical options approved by the US Food and Drug Administration for preventive therapy. Of these tamoxifen has greater efficacy and can be used in premenopausal women, but raloxifene has fewer side-effects. Two newer drugs in this class, lasofoxifene and arzoxifene, also show efficacy and possibly a better overall risk-benefit profile, but need further assessment. Aromatase inhibitors might be more efficacious, and results of prevention trials are eagerly awaited. Newer agents, notably bisphosphonates and metformin, have shown promise in observational studies and need to be assessed in randomised prevention trials. Other agents, such as aspirin, other non-steroidal anti-inflammatory drugs, COX-2 inhibitors, retinoids, rexinoids, and dietary components have limited effects or are in the early phases of investigation. New contralateral tumours in women with breast cancer might be generally useful as a model for prevention, as has been seen for tamoxifen. If valid such a model would facilitate the design of simpler, cheaper, and better-focused trials for assessing new agents.
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U2 - 10.1016/S1470-2045(11)70030-4
DO - 10.1016/S1470-2045(11)70030-4
M3 - Review article
C2 - 21441069
AN - SCOPUS:79955479172
SN - 1470-2045
VL - 12
SP - 496
EP - 503
JO - The lancet oncology
JF - The lancet oncology
IS - 5
ER -