Clin Cancer Res:小剂量他莫西芬能有效地降低胸部放疗过的癌症幸存者的乳腺癌风险

2021-01-15 MedSci原创 MedSci原创

低剂量他莫昔芬可降低乳腺癌风险,但仍未在接受过胸部放射的癌症幸存者中进行测试--这是一个乳腺癌风险与携带BRCA突变个体的相当的人群。本研究假设小剂量他莫昔芬可安全有效的降低与辐射相关的乳腺癌风险。

低剂量他莫昔芬可降低乳腺癌风险,但仍未在接受过胸部放射的癌症幸存者中进行测试--这是一个乳腺癌风险与携带BRCA突变个体的相当的人群。本研究假设小剂量他莫昔芬可安全有效的降低与辐射相关的乳腺癌风险。

该研究是在美国15个地点进行的一项由研究者发起的、随机的、双盲、安慰剂对照的IIb期试验(FDA IND107367)。招募了25岁及以上的、截止40岁时累计胸部放射达12Gy及以上的个体。受试者被随机分组,接受小剂量他莫昔芬(5 mg/天)或安慰剂,为期2年。主要终点是基线、1年和2年的乳腺致密影。胰岛素生长因子-1(IGF-1)在乳腺癌发生中具有一定作用;基线、1年和2年的循环IGF-1和IGF-BP3水平为次要终点。

乳腺致密影

IGF-1

IGFBP-3

2010-2016年期间,共招募了72位受试者:小剂量他莫昔芬组 34人,安慰剂组 38人,中位年龄 43.8岁(35-49岁),均可纳入评估。受试者接受的中位胸部放射剂量为30.3Gy。与安慰剂组相比,服用小剂量他莫昔芬的受试者乳腺致密影(p=0.02)和IGF-1(p<0.0001)水平显著降低,而IGFBP-3水平显著升高(p=0.02)。治疗组之间的毒性生物标志物(血清骨特异性碱性磷酸酶、脂质和抗凝血酶III、尿N-端肽交联)没有差异。无任何与小剂量他莫西芬相关的3-4级不良反应。

综上,该试验表明,小剂量他莫西芬能有效地降低乳腺癌风险生物标志物,或可作为这类人群的一种降低乳腺癌风险的策略。

原始出处:

Bhatia Smita,Palomares Melanie R,Hageman Lindsey et al. A Randomized Phase IIb Study of Low-dose Tamoxifen in Chest-irradiated Cancer Survivors at Risk for Breast Cancer. Clin Cancer Res, 2020, 10.1158/1078-0432.CCR-20-3609.

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    2021-08-19 pyaili
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    2021-05-04 xugc
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    2021-01-17 rayms

    学习了#乳腺癌#

    0

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