Chemoprevention backgrounder: Working for a future of cancer chemoprevention

what is already the biggest chemoprevention success story to date - the use of tamoxifen, a selective estrogen receptor modulator (SERM), to ward off recurrence of breast cancer.

M. D. Anderson, as a single institution, was the largest recruiter of patients nationally in the trial that proved the value of tamoxifen. Under the guidance of Therese Bevers, M.D., an associate professor of the Department of Clinical Cancer Prevention and director of the Cancer Prevention Center and the Prevention Outreach Programs,M. D. Anderson also is one of the top recruiters in the trial that is now seeking to find a better alternative to tamoxifen.

Tamoxifen blocks the effects of the estrogen in the body, and because 80 percent of breast cancers are dependent on estrogen hormones, the drug has a powerful anti-cancer effect - it decreases the risk of invasive cancer by half in women at risk, says Bevers. But tamoxifen is associated with some serious side effects, so researchers are testing the newer SERM, raloxifene, in one of the largest breast cancer prevention studies ever. The trial, known as STAR (The Study of Tamoxifen and Raloxifene), has recruited more than 19,000 volunteers at more than 400 centers, including 217 at M. D. Anderson, and an additional 170 at M. D. Anderson satellite sites.

Raloxifene, used to prevent osteoporosis, may have fewer side effects than tamoxifen, Bevers says. But while the results of STAR likely will be known in the next year or two, approaches are being investigated at M. D. Anderson that will help speed up investigation of even newer classes of estrogen blockers and other chemopreventive agents such as COX-2 inhibitors, she says.

For example, Banu Arun, M.D., is identifying biomarkers in breast cancer cells that will quickly tell researchers whether or not potential chemopreventive drugs are having any effect. "This is so important because long-term chemoprevention trials are expensive and take a long time to condu

Contact: Nancy Jensen
University of Texas M. D. Anderson Cancer Center

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