Prevention of breast cancer by newer SERMs in the future.

The selective oestrogen receptor modulators (SERMs) tamoxifen has been shown to reduce the incidence of oestrogen receptor positive breast cancer by about 60 to 70% in healthy high risk women. The oestrogenic effects of tamoxifen caused a beneficial effect of reduced bone loss and fracture risk in postmenopausal women. However there was also significant gynaecological toxicity including an increased risk of endometrial cancer.

Lenalidomide in multiple myeloma.

Treatment options for patients have increased over the last few years, especially with the availability of novel agents for routine care and within clinical trials. Owing to the promising activity seen with lenalidomide in the relapsed/refractory setting, its use has now expanded to induction and maintenance therapy. It is generally well tolerated and the side effects, including hematological toxicity and thromboembolic complications, are usually easily managed.

Prevention of breast cancer using SERMs.

The development of breast cancer is dependant in part on oestrogen. Suppression of ovarian function or use of anti-oestrogens will reduce the incidence of breast cancer. Many trials have now been done involving tens of thousands of healthy women evaluating the use of selective oestrogen receptor modulators to reduce the risk of breast cancer in healthy women.

Red clover isoflavones are safe and well tolerated in women with a family history of breast cancer.

Objective: To assess the safety and tolerability of a standardized 40 mg red clover isoflavone dietary supplement (Promensil, Novogen) in women with a family history of breast cancer to evaluate the feasibility of using the supplement for prevention of breast cancer in healthy women.

Study Design: Healthy women aged 35-70 years (n = 401) with at least one first-degree relative with breast cancer received red clover isoflavones or placebo for three years in a randomized, double-blind, placebo-controlled pilot trial. Participants were assessed clinically and blood samples taken for biochemical analysis every six months.

Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial.

Background: Several clinical trials have reported an early reduction in breast cancer incidence in healthy women using tamoxifen to reduce their risk of breast cancer but have not reported longer follow-up data for the evaluation of breast cancer prevention. We report the blinded 20-year follow-up (median follow-up = 13 years) of the Royal Marsden trial to identify any long-term prevention of breast cancer associated with tamoxifen treatment.

Methods: We randomly assigned 2494 healthy women to oral tamoxifen (20 mg/day) or placebo for 8 years.

Oral bisphosphonates as adjuvant therapy for operable breast cancer.

Bone is the most common site of metastatic spread from primary operable breast cancer, causing pain, fractures, and hypercalcemia. This spread depends on the release of osteolytic substances by the cancer cells, which activate osteoclasts to cause bone resorption. The osteoclasts also release growth factors that can act back on the cancer cells to activate growth.