Tamoxifen: Catalyst for the change to targeted therapy

• Published in: European journal of cancer (1990) Vol. 44; no. 1; pp. 30 - 38
• Main Author: Jordan, V. Craig
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.01.2008; Elsevier
• Subjects: Animals; Antineoplastic Agents, Hormonal - history; Antineoplastic Agents, Hormonal - therapeutic use; Antioestrogen; Biological and medical sciences; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - history; Chemoprevention; Chemoprevention - history; Female; Hematology, Oncology and Palliative Medicine; History, 20th Century; History, 21st Century; Humans; Medical sciences; Osteoporosis - history; Osteoporosis - prevention & control; Pharmacology. Drug treatments; Raloxifene; Raloxifene Hydrochloride - history; Raloxifene Hydrochloride - therapeutic use; Rats; Selective Estrogen Receptor Modulators - history; Selective Estrogen Receptor Modulators - therapeutic use; Selective oestrogen receptor modulator; Tamoxifen; Tamoxifen - history; Tamoxifen - therapeutic use; Tumors; Selective oestrogen receptor modulator; Breast cancer; Raloxifene; Antioestrogen; Tamoxifen; Chemoprevention; Antineoplastic agent; Estrogen receptor; Chemoprophylaxis; Targeted therapy; Antiestrogen; Antihormone; Benzothiophene derivatives; Prevention; Selective estrogen receptor modulator; Cancerology; modulator; Selective oestrogen receptor; Non steroid compound; Pharmacology; Malignant tumor; Tamoxifene; Mammary gland diseases; Chemotherapy; Treatment; Agonist antagonist; Cancer; Hormonal receptor
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2007.11.002

Abstract In the early 1970s, a failed post-coital contraceptive, ICI 46,474, was reinvented as tamoxifen, the first targeted therapy for breast cancer. A cluster of papers published in the European Journal of Cancer described the idea of targeting tamoxifen to patients with oestrogen receptor positive tumours, and proposed the strategic value of using long-term tamoxifen therapy in an adjuvant setting with a consideration of the antitumour properties of the hydroxylated metabolites of tamoxifen. At the time, these laboratory results were slow to be embraced by the clinical community. Today, it is estimated that hundreds of thousands of breast cancer patients are alive today because of targeted long-term adjuvant tamoxifen therapy. Additionally, the first laboratory studies for the use of tamoxifen as a chemopreventive were published. Eventually, the worth of tamoxifen was tested as a chemopreventive and the drug is now known to have an excellent risk benefit ratio in high risk pre-menopausal women. Overall, the rigorous investigation of the pharmacology of tamoxifen facilitated tamoxifen’s ubiquitous use for the targeted treatment of breast cancer, chemoprevention and pioneered the exploration of selective oestrogen receptor modulators (SERMs). This new concept subsequently heralded the development of raloxifene, a failed breast cancer drug, for the prevention of osteoporosis and breast cancer without the troublesome side-effect of endometrial cancer noted in post-menopausal women who take tamoxifen. Currently, the pharmaceutical industry is exploiting the SERM concept for all members of the nuclear receptor superfamily so that medicines can now be developed for diseases once thought impossible.