2012; Nᵒ 17, 91-95 ISSN 0976 – 044X
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Prospective Study on Gynaecological Effects of Two Antioestrogens Tamoxifen and Toremifene in Postmenopausal Women
British Journal of Cancer (2001) 84(7), 897–902 © 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2001.1703, available online at http://www.idealibrary.com on http://www.bjcancer.com Prospective study on gynaecological effects of two antioestrogens tamoxifen and toremifene in postmenopausal women MB Marttunen1, B Cacciatore1, P Hietanen2, S Pyrhönen2, A Tiitinen1, T Wahlström3 and O Ylikorkala1 1Departments of Obstetrics and Gynecology, Helsinki University Central Hospital, P.O. Box 140, FIN-00029 HYKS, Finland; 2Department of Oncology, Helsinki University Central Hospital, P.O. Box 180, FIN-00029 HYKS, Finland; 3Department of Pathology, Helsinki University Central Hospital, P.O. Box 140, FIN-00029 HYKS, Finland Summary To assess and compare the gynaecological consequences of the use of 2 antioestrogens we examined 167 postmenopausal breast cancer patients before and during the use of either tamoxifen (20 mg/day, n = 84) or toremifene (40 mg/day, n = 83) as an adjuvant treatment of stage II–III breast cancer. Detailed interview concerning menopausal symptoms, pelvic examination including transvaginal sonography (TVS) and collection of endometrial sample were performed at baseline and at 6, 12, 24 and 36 months of treatment. In a subgroup of 30 women (15 using tamoxifen and 15 toremifene) pulsatility index (PI) in an uterine artery was measured before and at 6 and 12 months of treatment. The mean (±SD) follow-up time was 2.3 ± 0.8 years. 35% of the patients complained of vasomotor symptoms before the start of the trial. This rate increased to 60.0% during the first year of the trial, being similar among patients using tamoxifen (57.1%) and toremifene (62.7%). -
PEMD-91-12BR Off-Label Drugs: Initial Results of a National Survey
11 1; -- __...._-----. ^.-- ______ -..._._ _.__ - _........ - t Ji Jo United States General Accounting Office Washington, D.C. 20648 Program Evaluation and Methodology Division B-242851 February 25,199l The Honorable Edward M. Kennedy Chairman, Committee on Labor and Human Resources United States Senate Dear Mr. Chairman: In September 1989, you asked us to conduct a study on reimbursement denials by health insurers for off-label drug use. As you know, the Food and Drug Administration designates the specific clinical indications for which a drug has been proven effective on a label insert for each approved drug, “Off-label” drug use occurs when physicians prescribe a drug for clinical indications other than those listed on the label. In response to your request, we surveyed a nationally representative sample of oncologists to determine: . the prevalence of off-label use of anticancer drugs by oncologists and how use varies by clinical, demographic, and geographic factors; l the extent to which third-party payers (for example, Medicare intermediaries, private health insurers) are denying payment for such use; and l whether the policies of third-party payers are influencing the treatment of cancer patients. We randomly selected 1,470 members of the American Society of Clinical Oncologists and sent them our survey in March 1990. The sam- pling was structured to ensure that our results would be generalizable both to the nation and to the 11 states with the largest number of oncologists. Our response rate was 56 percent, and a comparison of respondents to nonrespondents shows no noteworthy differences between the two groups. -
Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object. -
Ribociclib (LEE011)
Clinical Development Ribociclib (LEE011) Oncology Clinical Protocol CLEE011G2301 (EarLEE-1) / NCT03078751 An open label, multi-center protocol for U.S. patients enrolled in a study of ribociclib with endocrine therapy as an adjuvant treatment in patients with hormone receptor-positive, HER2- negative, high risk early breast cancer Authors Document type Amended Protocol Version EUDRACT number 2014-001795-53 Version number 02 (Clean) Development phase II Document status Final Release date 17-Apr-2018 Property of Novartis Confidential May not be used, divulged, published or otherwise disclosed without the consent of Novartis Template version 22-Jul-2016 Novartis Confidential Page 2 Amended Protocol Version 02 (Clean) Protocol No. CLEE011G2301 Table of contents Table of contents ................................................................................................................. 2 List of tables ........................................................................................................................ 5 List of abbreviations ............................................................................................................ 6 Glossary of terms ................................................................................................................. 9 Protocol summary .............................................................................................................. 10 Amendment 2 (17-Apr-2018) ............................................................................................ 14 -
Toremifene (Fareston)
Clinical Policy: Toremifene (Fareston) Reference Number: PA.CP.PMN.126 Effective Date: 10.17.18 Last Review Date: 04.17.19 Revision Log Description Toremifene (Fareston®) is an estrogen agonist/antagonist. FDA Approved Indication(s) Fareston is indicated for the treatment of metastatic breast cancer in postmenopausal women with estrogen-receptor positive or unknown tumors. Policy/Criteria Provider must submit documentation (such as office chart notes, lab results or other clinical information) supporting that member has met all approval criteria. It is the policy of health plans affiliated with PA Health & Wellness® that Fareston is medically necessary when the following criteria are met: I. Initial Approval Criteria A. Breast Cancer (must meet all): 1. Diagnosis of recurrent or metastatic breast cancer; 2. Prescribed by or in consultation with an oncologist; 3. Failure of a 1-month trial of tamoxifen at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced; 4. Failure of a 1-month trial of an aromatase inhibitor (e.g., anastrozole, exemestane, letrozole) at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced (see Appendix B); 5. Request meets one of the following (a or b): a. Dose does not exceed 60 mg per day (1 tablet/day); b. Dose is supported by practice guidelines or peer-reviewed literature for the relevant off-label use (prescriber must submit supporting evidence). Approval duration: 12 months B. Soft Tissue Sarcoma - Desmoid Tumors (off-label) (must meet all): 1. Diagnosis of desmoid tumor or aggressive fibromatosis; 2. Prescribed by or in consultation with an oncologist; 3. -
Hormone Replacement Therapy and Osteoporosis
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers— patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services. Systematic Evidence Review Number 12 Hormone Replacement Therapy and Osteoporosis Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 2101 East Jefferson Street Rockville, MD 20852 http://www.ahrq.gov Contract No. 290-97-0018 Task Order No. 2 Technical Support of the U.S. Preventive Services Task Force Prepared by: Oregon Health Sciences University Evidence-based Practice Center, Portland, Oregon Heidi D. Nelson, MD, MPH August 2002 Preface The Agency for Healthcare Research and Quality (AHRQ) sponsors the development of Systematic Evidence Reviews (SERs) through its Evidence-based Practice Program. With guidance from the third U.S. Preventive Services Task Force∗ (USPSTF) and input from Federal partners and primary care specialty societies, two Evidence-based Practice Centers—one at the Oregon Health Sciences University and the other at Research Triangle Institute-University of North Carolina—systematically review the evidence of the effectiveness of a wide range of clinical preventive services, including screening, counseling, immunizations, and chemoprevention, in the primary care setting. -
Pharmacology/Therapeutics II Block III Lectures 2013-14
Pharmacology/Therapeutics II Block III Lectures 2013‐14 66. Hypothalamic/pituitary Hormones ‐ Rana 67. Estrogens and Progesterone I ‐ Rana 68. Estrogens and Progesterone II ‐ Rana 69. Androgens ‐ Rana 70. Thyroid/Anti‐Thyroid Drugs – Patel 71. Calcium Metabolism – Patel 72. Adrenocorticosterioids and Antagonists – Clipstone 73. Diabetes Drugs I – Clipstone 74. Diabetes Drugs II ‐ Clipstone Pharmacology & Therapeutics Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones, March 20, 2014 Lecture Ajay Rana, Ph.D. Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones Date: Thursday, March 20, 2014-8:30 AM Reading Assignment: Katzung, Chapter 37 Key Concepts and Learning Objectives To review the physiology of neuroendocrine regulation To discuss the use neuroendocrine agents for the treatment of representative neuroendocrine disorders: growth hormone deficiency/excess, infertility, hyperprolactinemia Drugs discussed Growth Hormone Deficiency: . Recombinant hGH . Synthetic GHRH, Recombinant IGF-1 Growth Hormone Excess: . Somatostatin analogue . GH receptor antagonist . Dopamine receptor agonist Infertility and other endocrine related disorders: . Human menopausal and recombinant gonadotropins . GnRH agonists as activators . GnRH agonists as inhibitors . GnRH receptor antagonists Hyperprolactinemia: . Dopamine receptor agonists 1 Pharmacology & Therapeutics Neuroendocrine Pharmacology: Hypothalamic and Pituitary Hormones, March 20, 2014 Lecture Ajay Rana, Ph.D. 1. Overview of Neuroendocrine Systems The neuroendocrine -
Effects of Toremifene, a Selective Estrogen Receptor Modulator, On
ISSN 2472-1972 Effects of Toremifene, a Selective Estrogen Receptor Modulator, on Spontaneous and Stimulated GH Secretion, IGF-I, and IGF-Binding Proteins in Healthy Elderly Subjects Ferdinand Roelfsema,1 Rebecca J. Yang,2 Paul Y. Takahashi,3 Dana Erickson,4 Cyril Y. Bowers,5 and Johannes D. Veldhuis2 1Department of Internal Medicine, Section of Endocrinology and Metabolism, Leiden University Medical Center, 2333 ZA Leiden, Netherlands; 2Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905; 3Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905; 4Department of Endocrinology, Mayo Clinic, Rochester, Minnesota 55905; and 5Department of Internal Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana 70112 Context: Estrogens amplify spontaneous and stimulated growth hormone (GH) secretion, whereas they diminish GH-dependent insulin-like growth factor (IGF)-I in a dose-dependent manner. Selective es- trogen receptor modulators (SERMs), including tamoxifen and toremifene, are widely adjunctively used in breast and prostate cancer. Although some endocrine effects of tamoxifen are known, few data are available for toremifene. Objective: To explore sex-dependent effects of toremifene on spontaneous 10-hour overnight GH se- cretion, followed by GH-releasing hormone–ghrelin stimulation. Additionally, effects on IGF-I, its binding proteins, and sex hormone–binding globulin (SHBG) were quantified. Participants and Design: Twenty men and 20 women, within an allowableagerangeof50to80years, volunteered for this double-blind, placebo-controlled prospective crossover study. Ten-minute blood sampling was done for 10 hours overnight and then for 2 hours after combined GH-releasing hormone–ghrelin injection. Main Outcome Measures: Pulsatile GH and stimulated GH secretion, and fasting levels of IGF-I, IGF- binding protein (IGFBP)1, IGFBP3, and SHBG. -
A Pharmaceutical Product for Hormone Replacement Therapy Comprising Tibolone Or a Derivative Thereof and Estradiol Or a Derivative Thereof
Europäisches Patentamt *EP001522306A1* (19) European Patent Office Office européen des brevets (11) EP 1 522 306 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.7: A61K 31/567, A61K 31/565, 13.04.2005 Bulletin 2005/15 A61P 15/12 (21) Application number: 03103726.0 (22) Date of filing: 08.10.2003 (84) Designated Contracting States: • Perez, Francisco AT BE BG CH CY CZ DE DK EE ES FI FR GB GR 08970 Sant Joan Despi (Barcelona) (ES) HU IE IT LI LU MC NL PT RO SE SI SK TR • Banado M., Carlos Designated Extension States: 28033 Madrid (ES) AL LT LV MK (74) Representative: Markvardsen, Peter et al (71) Applicant: Liconsa, Liberacion Controlada de Markvardsen Patents, Sustancias Activas, S.A. Patent Department, 08028 Barcelona (ES) P.O. Box 114, Favrholmvaenget 40 (72) Inventors: 3400 Hilleroed (DK) • Palacios, Santiago 28001 Madrid (ES) (54) A pharmaceutical product for hormone replacement therapy comprising tibolone or a derivative thereof and estradiol or a derivative thereof (57) A pharmaceutical product comprising an effec- arate or sequential use in a method for hormone re- tive amount of tibolone or derivative thereof, an effective placement therapy or prevention of hypoestrogenism amount of estradiol or derivative thereof and a pharma- associated clinical symptoms in a human person, in par- ceutically acceptable carrier, wherein the product is pro- ticular wherein the human is a postmenopausal woman. vided as a combined preparation for simultaneous, sep- EP 1 522 306 A1 Printed by Jouve, 75001 PARIS (FR) 1 EP 1 522 306 A1 2 Description [0008] The review article of Journal of Steroid Bio- chemistry and Molecular Biology (2001), 76(1-5), FIELD OF THE INVENTION: 231-238 provides a review of some of these compara- tive studies. -
Product Data Sheet
Inhibitors Product Data Sheet Chlorotrianisene • Agonists Cat. No.: HY-B2158 CAS No.: 569-57-3 Molecular Formula: C₂₃H₂₁ClO₃ • Molecular Weight: 380.86 Screening Libraries Target: Estrogen Receptor/ERR; COX Pathway: Others; Immunology/Inflammation Storage: Powder -20°C 3 years 4°C 2 years In solvent -80°C 6 months -20°C 1 month SOLVENT & SOLUBILITY In Vitro DMSO : 100 mg/mL (262.56 mM; Need ultrasonic) Mass Solvent 1 mg 5 mg 10 mg Concentration Preparing 1 mM 2.6256 mL 13.1282 mL 26.2564 mL Stock Solutions 5 mM 0.5251 mL 2.6256 mL 5.2513 mL 10 mM 0.2626 mL 1.3128 mL 2.6256 mL Please refer to the solubility information to select the appropriate solvent. In Vivo 1. Add each solvent one by one: 10% DMSO >> 90% (20% SBE-β-CD in saline) Solubility: 2.5 mg/mL (6.56 mM); Suspended solution; Need ultrasonic 2. Add each solvent one by one: 10% DMSO >> 90% corn oil Solubility: ≥ 2.5 mg/mL (6.56 mM); Clear solution BIOLOGICAL ACTIVITY Description Chlorotrianisene is a long-acting non-steroidal estrogen and an orally active estrogen receptor modulator. Chlorotrianisene exhibits antiestrogenic activity. Chlorotrianisene potently inhibits the enzyme COX-1 and inhibits platelet aggregation in whole blood[1][2][3]. IC₅₀ & Target Estrogen receptor[1] COX-1[2] In Vitro Comparison of intracellular estrogen receptor (ER) affinities of Chlorotrianisene with respective rat uterine cytosolic ER affinities has initially suggested the potential for activation of ER as a mechanism of growth stimulation. Chlorotrianisene [1] exhibits concentration dependent cell growth stimulation with an EC50 of 28 nM and a Ki of 500 nM in MCF-7 cells . -
INTERRELATIONSHIPS of the ESTROGEN-PRODUCING ENZYMES NETWORK in BREAST CANCER DISSERTATION Presented in Partial Fulfillment Of
INTERRELATIONSHIPS OF THE ESTROGEN-PRODUCING ENZYMES NETWORK IN BREAST CANCER DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Wendy L. Rich, M.S. ∗∗∗∗∗ The Ohio State University 2009 Dissertation Committee: Approved by Pui-Kai Li, Ph.D., Adviser Robert W. Brueggemeier, Ph.D. Karl A. Werbovetz, Ph.D. Adviser Graduate Program in Pharmacy Charles L. Shapiro M.D. ABSTRACT In the United States, breast cancer is the most common non-skin malignancy and the second leading cause of cancer-related death in women. However, earlier detection and new, more effective treatments may be responsible for the decrease in overall death rates. Approximately 60% of breast tumors are estrogen receptor (ER) positive and thus their cellular growth is hormone-dependent. Elevated levels of estrogens, even in post- menopausal women, have been implicated in the development and progression of hormone-dependent breast cancer. Hormone therapies seek to inhibit local estrogen action and biosynthesis, which can be produced by pathways utilizing the enzymes aromatase or steroid sulfatase (STS). Cyclooxygenase-2 (COX-2), typically involved in inflammation processes, is a major regulator of aromatase expression in breast cancer cells. STS, COX-2, and aromatase are critical for estrogen biosynthesis and have been shown to be over-expressed in breast cancer. While there continues to be extensive study and successful design of potent aromatase inhibitors, much remains unclear about the regulation of STS and the clinical applications for its selective inhibition. Further studies exploring the relationships of STS with COX-2 and aromatase enzymes will aid in the understanding of its role in cancer cell growth and in the development of future hormone- dependent breast cancer therapies. -
Steroidal Estrogens
FINAL Report on Carcinogens Background Document for Steroidal Estrogens December 13 - 14, 2000 Meeting of the NTP Board of Scientific Counselors Report on Carcinogens Subcommittee Prepared for the: U.S. Department of Health and Human Services Public Health Service National Toxicology Program Research Triangle Park, NC 27709 Prepared by: Technology Planning and Management Corporation Canterbury Hall, Suite 310 4815 Emperor Blvd Durham, NC 27703 Contract Number N01-ES-85421 Dec. 2000 RoC Background Document for Steroidal Estrogens Do not quote or cite Criteria for Listing Agents, Substances or Mixtures in the Report on Carcinogens U.S. Department of Health and Human Services National Toxicology Program Known to be Human Carcinogens: There is sufficient evidence of carcinogenicity from studies in humans, which indicates a causal relationship between exposure to the agent, substance or mixture and human cancer. Reasonably Anticipated to be Human Carcinogens: There is limited evidence of carcinogenicity from studies in humans which indicates that causal interpretation is credible but that alternative explanations such as chance, bias or confounding factors could not adequately be excluded; or There is sufficient evidence of carcinogenicity from studies in experimental animals which indicates there is an increased incidence of malignant and/or a combination of malignant and benign tumors: (1) in multiple species, or at multiple tissue sites, or (2) by multiple routes of exposure, or (3) to an unusual degree with regard to incidence, site or type of tumor or age at onset; or There is less than sufficient evidence of carcinogenicity in humans or laboratory animals, however; the agent, substance or mixture belongs to a well defined, structurally-related class of substances whose members are listed in a previous Report on Carcinogens as either a known to be human carcinogen, or reasonably anticipated to be human carcinogen or there is convincing relevant information that the agent acts through mechanisms indicating it would likely cause cancer in humans.