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Brustkrebs - Prävention

Allgemeines

In Risikokollektiven postmenopausaler Frauen lässt sich die Brustkrebs-Inzidenz durch SERM senken.

Liste der Studien

NCIC-CTG-MAP.3 (1)

Der Aromatase-Inhibitor Exemestan führt zu einer 65 %igen Risiko-Reduktion für Brustkrebs nach einem medianen Follow-up von 3 Jahren.

NNT (Number needed to treat): 94 (3 Jahre), 26 (über 5 Jahre).

SERM

selektive Östrogenrezeptormodulatoren

  • Tamoxifen
  • Raloxifen
  • Lasofoxifen
  • Arzoxifen

Metaanalyse (2)

Metaanalyse SERM versus Placebo

Stiftung Cancer Research UK (2)

SERMalle Tamoxifen Raloxifen Lasofoxifen Arzoxifen
Anzahl Frauen 83 399        
Reduktion der Brustkrebsinzidenz, Median 65 Monate38%     
Reduktion der Brustkrebsinzidenz, 1 - 5 Jahre 42%     
Reduktion der Brustkrebsinzidenz, 6 - 10 Jahre 25%     
Reduktion der Brustkrebsinzidenz, NNT 42     
Brustkrebs - Mortalität gleich     
Gesamt - Mortalität gleich     
thromboembolischer Ereignisse, RR   1,6 1,45 2,55 2,38
Endometriumkarzinome, RR   2,18 1,09 ? ?


nach Daten von (2)

Quellen

1.) Goss PE, et al.:
Exemestane for breast-cancer prevention in postmenopausal women.
NEJM 364(2011): 2381–91

2.) Cuzick J, et al.:
Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data.
Lancet 2013; e-pub before print: doi: 10.1016/S0140-6736(13)60140-3.

3.) Powles T, et al.:
Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trial.
Lancet 352 (1998): 98–101

4.) Powles TJ, et al.:
Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial.
J Natl Cancer Inst 99 (2007): 283–290

5.) Cuzick J, et al.:
First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial.
Lancet 360 (2002): 817–824

6.) Cuzick J, et al.:
Long-term results of tamoxifen prophylaxis for breast cancer—96-month follow-up of the randomized IBIS-I trial.
J Natl Cancer Inst 99 (2007): 272–282

7.) Fisher B, et al.:
Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.
J Natl Cancer Inst, 90 (1998): 1371–1388

8.) Fisher B, et al.:
Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study.
J Natl Cancer Inst 97 (2005):1652–1662

9.) Veronesi U, et al.:
Prevention of breast cancer with tamoxifen: preliminary findings from the Italian randomised trial among hysterectomised women. Italian Tamoxifen Prevention Study.
Lancet 352 (1998): 93–97

10.) Veronesi U, et al.:
Tamoxifen for the prevention of breast cancer: late results of the Italian Randomized Tamoxifen Prevention Trial among women with hysterectomy.
J Natl Cancer Inst 99 (2007): 727–737

11.) Cauley JA, et al.:
Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial. Multiple outcomes of raloxifene evaluation.
Breast Cancer Res Treat 65 (2001):125–134

12.) Martino S, et al.:
Continuing outcomes relevant to Evista: breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of raloxifene.
J Natl Cancer Inst 96 (2004): 1751–1761

13.) Barrett-Connor E, et al.:
Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women.
N Engl J Med 355 (2006): 125–137

14.) Vogel VG, et al.:
Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial.
JAMA, 295 (2006): 2727–2741

15.) Vogel VG, et al.:
Update of the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene (STAR) P-2 Trial: preventing breast cancer.
Cancer Prev Res 3 (2010): 696–706

16.) Cummings SR, et al.:
Lasofoxifene in postmenopausal women with osteoporosis.
N Engl J Med 362 (2010): 686–696

17.) LaCroix AZ, et al.:
Breast cancer incidence in the randomized PEARL trial of lasofoxifene in postmenopausal osteoporotic women.
J Natl Cancer Inst 102 (2010): 1706–1715

18.) Cummings SR, et al.:
Arzoxifene for prevention of fractures and invasive breast cancer in postmenopausal women.
J Bone Miner Res 26 (2011): 397–404

19.) Powles TJ, et al.:
Breast cancer incidence in postmenopausal women with osteoporosis or low bone mass using arzoxifene.
Breast Cancer Res Treat 134 (2012): 299–306

20.) Cuzick J:
Aromatase inhibitors in prevention—data from the ATAC (arimidex, tamoxifen alone or in combination) trial and the design of IBIS-II (the second International Breast Cancer Intervention Study).
Recent Results Cancer Res 163 (2003): 96–103

21.) Goss PE, et al.:
Exemestane for breast-cancer prevention in postmenopausal women.
N Engl J Med 364 (2011): 2381–2391

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Mamma - Karzinom Gynäkologische Onkologie

 

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