A recent review [1] was intriguing, since it brought again to our attention the search for a desired molecule which should have optimal dual characteristics: inducing estrogen-like effects on menopause-related symptoms on the one hand, but avoiding the potentially serious adverse effects of postmenopausal hormone therapy on the other hand. Here is an Abstract of this review:
Vulvovaginal atrophy (VVA) in postmenopausal breast cancer patients has a significant impact on quality of life. While the etiology of VVA is primarily related to low estrogen levels seen in menopause, women with breast cancer have an added risk of VVA induced by a combination of chemotherapy, hormonal therapy, and menopause. Ospemifene is a new, non-hormonal selective estrogen receptor modulator (SERM) triphenylethylene derivative that is effective in treating VVA in postmenopausal women. Although other SERMs have antagonistic effects on the vagina, ospemifene exerts an estrogen-like effect on the vaginal epithelium. The review focuses on data demonstrating the antiestrogenic activity of ospemifene in several unique breast cancer animal models, and the implications for utilizing ospemifene in patients with breast cancer suffering from VVA.
Author(s)
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Amos Pines
Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel
Citations
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Wurz GT, Soe LH, Degregorio MW. Ospemifene, vulvovaginal atrophy, and breast cancer. Maturitas 2013 Jan 15. Epub ahead of print.
http://www.ncbi.nlm.nih.gov/pubmed/23332519 -
Fisher B, Costantino JP, Wickerham DL, 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 1998;90:137188.
http://www.ncbi.nlm.nih.gov/pubmed/9747868 -
Vogel VG, Costantino JP, Wickerham DL, 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 2006;295:2727-41.
http://www.ncbi.nlm.nih.gov/pubmed/16754727 -
Fisher B, Costantino JP, Redmond CK, et al. Endometrial cancer in tamoxifen-treated breast cancer patients: findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst 1994;86:527-37.
http://www.ncbi.nlm.nih.gov/pubmed/8133536 -
Checa MA, Garrido A, Prat M, et al. A comparison of raloxifene and calcium plus vitamin D on vaginal atrophy after discontinuation of long-standing postmenopausal hormone therapy in osteoporotic women. A randomized, masked-evaluator, one-year, prospective study. Maturitas 2005;52:70-7.
http://www.ncbi.nlm.nih.gov/pubmed/16143228 -
Bachmann GA, Komi JO. Ospemifene effectively treats vulvovaginal atrophy in postmenopausal women: results from a pivotal phase 3 study. Menopause 2010;17:4806.
http://www.ncbi.nlm.nih.gov/pubmed/20032798
