Which of the following is used to treat hormone- responsive breast cancer?
Ans. d. Tamoxifen (Ref: Goodman and Gilman 12/e p1756-1757)Tamoxifen is used to treat hormone- responsive breast cancer."Tamoxifen was first synthesized in 1966 and initially developed as on oral contraceptive but instead was found to induce ovulation and proved to have anti-proliferative effect on estrogen-dependent breast cancer. Tamoxifen is a competitive inhibitor of estradiol, binding to the estrogen receptor. It has become a standard agent as a result of its anti-cancer activity and good tolerability profile. Tamoxifen is prescribed for the prevention of breast cancer in high-risk patients, for the adjuvant therapy of early stage breast cancer, and for the therapy of advanced breast cancer. It also prevents development of breast cancer in woman at high risk based on a strong family history, prior non-malignant breast pathology, or inheritance of the BRCA1 or BRCA2 genes."- Goodman and Gilman 12/e p1756-1757TamoxifenTamoxifen is a standard hormonal treatment of breast cancer in both premenopausal and postmenopausal womenQTamoxifen is effective in Estrogen Receptor (ER) positive breast carcinoma but some ER negative tumors also respond to tamoxifenQ.Tamoxifen is approved for primary prophylaxis of breast cancer in high risk womenQIf reduces the recurrence rate of breast cancer in ipsilateral as well contralateral breastQTamoxifen is associated with reduced risk of cancer in the contralateral breastQ.Dose: 10 mg BD X 5-yearsQWhile tamoxifen blocks estrogen receptors on the breast, it stimulates these receptors in the uterus (because tamoxifen is a partial against of ER), may lead to endometrial hyperplasia and endometrial cancerQPotent antagonist in breast carcinoma cells, blood vessels and at some peripheral sitesQQPartial agonist in the uterus, bone, liver and pituitaryAdverse Effects of Tamoxifen* Hot flushes, nausea and vomiting (MC)Q* Menstrual irregularitiesQ, vaginal bleeding, discharge, pruritus vulvae and dermatitis* Endometrial cancerQ* ThromboembolismQ* CataractQ* Retinal deposits and decreased visual acuity
Cyptroterone acetate
Clomiphene citrate
Diethylstibestrol
Tamoxifen
Breast Cancer - Treatments