I saw CNN and C-SPAN, but not 20/20 and CBS. I suspect that all reports were similar. Tamoxifen does reduce the incidence of breast cancer in high risk patients. However, it's side effects (uterine cancer and blood clots) are serious and sometimes fatal. The trial has been too short to determine exactly when it should be taken and how long its benefits last (does it prevent breast cancer or merely delay it). It seems to be most useful for younger, high risk patients.
Evista (Raloxifene) may be better with a higher prevention rate (at least short term in older, postmenopausal women) and lower rate of uterine cancer. It will be entered into a head to head trial against Tamoxifen to specifically address its relative efficacy compared to Tamoxifen.
However, better compounds are being developed, which could further increae the prevention frequency and reduce the negative side effects (uterine cancer and blood clots). Thus, while there has been a significant conceptual advance (SERMs can prevent breast cancer in women), there is much room for improvement and there are many unanswered questions.
LGND is involved with several SERMs (PFE's Droloxifene and CP-366,156; AHP's TSE424, and LLY's Evista). The LLY program seeks to combine SERMs with Rexinoids (like Targretin, LGD1268, and LGD1324).
Approval of Targretin for CTCL could generate significant off label sales for other cancers (including breast cancer treatment and possibly prevention), type II diabetes (also for prevention and treatment), and osteoporosis. In all cases. Targretin could be used as monotherapy or combination therapy. It is currently in monotherapy trials for treating many cancers and type II diabetes and in combination therapy (with Tamoxifen) for treating breast cancer. It is slated for advanced treatment trials for type II diabetes (both as monotherpay and combination therapy). So far it is not slated for treatment or prevention of osteoporosis. |
