A phase-III prevention trial of low-dose tamoxifen in postmenopausal hormone replacement therapy users: the HOT study

DeCensi, Andrea; Bonanni, Bernardo; Maisonneuve, Patrick; Serrano, Davide; Omodei, U.; Varricchio, Claudette G.; Cazzaniga, Massimiliano; Lazzeroni, Matteo; Rotmensz, Nicole; Santillo, B.; Sideri, Mario; Cassano, Enrico; Belloni, C; Muraca, Maria Grazia; Segnan, Nereo; Masullo, P.; Costa, Alberto; Monti, N.; Vella, Anna Maria; Bisanti, Luigi; D’Aiuto, Giuseppe; Veronesi, Umberto

doi:10.1093/annonc/mdt244

Cited by 30 publications

(35 citation statements)

References 38 publications

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“…Tamoxifen showed a significant trend in luminal‐A tumors (RR, 0.32; 95% CI 0.12–0.86). No differences in serious adverse events were observed compared to placebo (Decensi et al., 2013).…”

Section: Selective Estrogen Receptor Modulators (Serms)mentioning

confidence: 93%

Cancer chemoprevention: Much has been done, but there is still much to do. State of the art and possible new approaches

2014

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Over the past three decades great efforts have been made in search of cancer chemoprevention strategies. The increase in knowledge of the long process from normal to cancer cell has enabled interventions in terms of lifestyle modifications, natural compounds or drugs to block or reverse the process. Great successes have been achieved, especially for breast and colorectal cancer. However, these strategies have yet to find clinical application on a large scale. In this article we identify the achievements, the pitfalls and the next steps to be taken to improve the efficacy and applicability of chemoprevention strategies. Among the crucial key points to be implemented are educational activities for physicians to appropriately disseminate the aim and indeed the culture of chemoprevention. It is essential to improve the risk-benefit balance, seeking the minimal active doses, intermittent schedules, a better characterization of the risk categories via a more personalized intervention based on individual characteristics, and ensure the containment of costs of public and private health prevention programs.

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Section: Selective Estrogen Receptor Modulators (Serms)mentioning

confidence: 93%

Cancer chemoprevention: Much has been done, but there is still much to do. State of the art and possible new approaches

2014

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“…Menopausal symptoms such as hot flashes, fatigue, sweating, insomnia, and arthralgia were more common in those taking exemestane IBIS-II [16] No significant differences in any of the cognitive tasks more women in the anastrozole group complained of hot flushes HOT [18] Serious adverse events did not differ between placebo and Tamoxifen Coronary heart syndrome (6 vs. 4), cerebrovascular events (2 vs. 5), VTE (2 vs. 5) and uterine cancers (3 vs. 1).…”

Section: Possible Additional Toxicity Due To Chemopreventionmentioning

confidence: 97%

Breast cancer prevention with anti-estrogens: review of the current evidence and future directions

2015

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There is a potential for reducing the incidence of breast cancer by modifying or changing the reversible risk factors like dietary modifications, modifications in the sedentary life habits, etc. One of such methods which has gained popularity now is chemoprevention. Many agents have been evaluated in the chemoprevention setting in females with increased risk of breast cancers. Metformin, NSAIDS, Bisphosphonates, and statins were evaluated by various investigators with variable results. One of the agents that have been proven to be beneficial in this setting is the anti-estrogens. A major disadvantage of chemoprevention is that unlike prophylactic mastectomy it can never reduce the risk to near zero although it reduces the risk significantly. Another issue is the compliance as chemoprevention with anti-estrogens will need to be continued for 5 years while surgery is a one-time procedure. Another disadvantage is the possible side effects peculiar to each drug used which may not be a significant concern in prophylactic mastectomy group. All these factors must also be kept in mind and properly explained to the patient before starting chemoprevention using anti-estrogens. Here in this review we intend to look into the large randomized controlled trials to quantify the present status of chemoprevention with anti-estrogens.

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“…Low‐dose tamoxifen at 5 mg/day has been evaluated in the randomized prospective HRT Opposed to Low‐dose Tamoxifen trial . There was a trend for reduced breast cancer incidence, but this was not statistically significant, and climacteric symptoms were significantly increased.…”

Section: Chemopreventionmentioning

confidence: 99%

Breast Cancer Prevention

Euhus

Diaz

2014

Breast J

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Breast cancer is the most common cancer in women with 232,670 new cases estimated in the USA for 2014. Approaches for reducing breast cancer risk include lifestyle modification, chemoprevention, and prophylactic surgery. Lifestyle modification has a variety of health benefits with few associated risks and is appropriate for all women regardless of breast cancer risk. Chemoprevention options have expanded rapidly, but most are directed at estrogen receptor positive breast cancer and uptake is low. Prophylactic surgery introduces significant additional risks of its own and is generally reserved for the highest risk women.

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A phase-III prevention trial of low-dose tamoxifen in postmenopausal hormone replacement therapy users: the HOT study

Abstract: The addition of low-dose tamoxifen to HRT did not significantly reduce breast cancer risk and increased climacteric symptoms in recently postmenopausal women. However, we noted beneficial trends in some subgroups which may deserve a larger study.

Cited by 30 publications

References 38 publications

Cancer chemoprevention: Much has been done, but there is still much to do. State of the art and possible new approaches

Cancer chemoprevention: Much has been done, but there is still much to do. State of the art and possible new approaches

Breast cancer prevention with anti-estrogens: review of the current evidence and future directions

Breast Cancer Prevention

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