Given Ligands pipeline, I am encouraged at the amount of coverage on Tamoxifen. Obviously, it is part emotional and as such is deemed "newsworthy". Below find an editorial from the Dallas Morning News, regarding Tamoxifen. Of particular interest is the concluding paragraph.
Breast Cancer
Tamoxifen study offers women encouraging news
04/10/98
This time, treatment led not to a cure but to something even better: prevention. A drug used for many years to keep advanced breast cancer from spreading can actually prevent breast cancer in some women.
About 13,400 women at increased risk for breast cancer enrolled in the multi-year study of tamoxifen. Half took the drug and half took a placebo; neither the women nor their doctors knew who was taking what.
Researchers halted the "blind" study when data showed women taking tamoxifen had a 45 percent decrease in breast cancer incidence. (This is standard practice whenever an experimental treatment has such clear benefits or risks that depriving patients of that information would be unethical.) The results were important, encouraging news.
Yet the results will not be easily applied in the real world.
While tamoxifen reduced breast cancer incidence, it sharply increased the risk of two life-threatening conditions: blood clots in the lungs and major veins, and endometrial cancer. Older women are particularly susceptible to those conditions and slightly likelier to benefit from tamoxifen. That leaves them with a medical quandary. Women contemplating preventative tamoxifen therapy will have to juggle complicated sets of variables and risks with their doctors.
Also, only 3 percent of study participants were minority women, despite extensive recruitment efforts. Black American women have higher breast cancer mortality rates than white women, even when they have equal access to medical care. Researchers must keep trying to enroll minorities in tamoxifen-related trials.
The trial has other implications. A month's supply of tamoxifen costs about $85 to $100. Will insurers pay that cost, for an indeterminate period, to lower the risk of breast cancer in higher-risk women? Will women without private insurance, or those on Medicare or Medicaid, have access to this therapy? Policy mavens will have to sort out those questions.
Tamoxifen isn't the ultimate breast cancer prevention drug. It carries too many risks. But now that researchers have shown tamoxifen can prevent some breast cancers, they have a standard for testing other drugs. Those new compounds may have fewer serious side effects. That possibility should give all women hope. |
