Endometrial
Raloxifene May Protect Against Endometrial Cancer
By American Society of Clinical Oncology
May 17, 2005, 01:54

A new analysis of patients taking raloxifene and tamoxifen shows that raloxifene may reduce the risk of endometrial cancer (cancer of the uterine lining), and confirms previous studies showing that tamoxifen increases the risk for the disease.

Tamoxifen has been shown to reduce the risk of breast cancer recurrence among women whose cancer is sensitive to estrogen ("hormone receptor positive"), and to reduce the risk of developing breast cancer among women at high risk for the disease. However, this study and others have found that tamoxifen also increases the risk of endometrial cancer. Raloxifene, which belongs to the same class of drugs as tamoxifen � called selective estrogen receptor modulators (SERMs) � is used to treat osteoporosis and may also reduce the risk of breast cancer. Unlike tamoxifen, however, raloxifene does not stimulate estrogen receptors in the uterine lining.

In a case-control study, researchers compared raloxifene and tamoxifen use between 547 women with endometrial cancer in the Philadelphia area and 1,412 women without cancer who served as controls. Patients were participants in the Women's Insights and Shared Experiences (WISE) study, a project at the University of Pennsylvania School of Medicine that is investigating hormone-related cancers in women. The control group was recruited by random-digit telephone dialing in the Philadelphia area.

Compared to non-users, the risk of endometrial cancer among women taking tamoxifen was 50% higher, while raloxifene users experienced a 50% lower risk. This benefit existed even among women who used raloxifene for less than three years.

"Endometrial cancer is the most common gynecologic cancer, so it's important to start thinking about strategies to reduce risk," said Angela DeMichele, MD, MSCE, Assistant Professor of Medicine at the Abramson Cancer Center and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, and the study's lead investigator. "If raloxifene proves effective at preventing both breast cancer and endometrial cancer, that information could weigh heavily on a woman's decision about which drug to choose."

Another study currently underway called the STAR trial (Study of Tamoxifen and Raloxifene) is comparing raloxifene and tamoxifen for reducing the risk of ever developing breast cancer. Data won't be reported until 2006, but may also reveal important findings regarding endometrial cancer risk.

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