Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 4 2000
Play
Audio Below:
Dr.
Loprinzi: With that we saw there was a reduction of hot flash scores
of about 27% with the placebo group, again consistent with what
we’ve seen time and time and again. At a dose of 37.5 mg/ day
there was a reduction of approximately 40%, which was statistically
significantly better than the 27%. And then, at a dose of 75 mg,
or 150 mg/ day, we saw about a 60% reduction of hot flashes with
no suggestion, whatsoever, that the 150 mg dose was any better for
reducing hot flashes than the 75 mg dose. We did note in that study
that the toxicity was substantially more with the 150 mg dose vs.
the 75 mg dose, and therefore, our end suggestion that 75 mg is
the maximal dose that we would recommend for using it for hot flashes.
Dr.
Love: And what kind of toxicity did you see at 75mg?
Dr.
Loprinzi: The drug seemed to be tolerable in the vast majority of
patients. There were four toxicities, we saw a total…one of
them only at the 150 mg dose, and the way I think of them is that
they are related to the alimentary tract. We saw dry mouth, which
didn’t seem to be very much of a problem. We saw nausea, which
was interesting in that it was a problem over the first week and
then in the vast majority of patients, despite continuing the medication,
the nausea went away. There were a few patients who had nausea and
vomiting and had to stop it within a few days of starting it, but
that was quite rare indeed. We saw some appetite suppression, which
some women would say that’s a bad side effect and others, probably
more, would say that’s a good side effect – being America
in this day and age. And the last side effect we saw was constipation,
but only at the higher dose, the 150 mg/day dose.
Biopsy
confirmed benign breast disease, postmenopausal use of exogenous
female hormones, and breast carcinoma risk. Byrne,
C.; Connolly, J. L.; Colditz, G. A., and Schnitt, S. J.. Cancer.
89(10):2046-2052, 2000 Nov 15.
Postmenopausal
estrogens - Opposed, unopposed, or none of the above Willett, W. C.; Colditz, G., and Stampfer, M. (Reprint available
from: Willett WC Harvard Univ, Sch Publ Hlth, Dept Nutr 667 Huntington
Ave Boston, MA 02115 USA).. Jama: Journal of the American Medical
Association. 283(4):534-535, 2000 Jan 26. No abstract
Re:
Effect of hormone replacement therapy on breast cancer risk: Estrogen
versus estrogen plus progestin Archer, D. F.; Bush, T., and Nachtigall, L. E. (Reprint available
from: Nachtigall LE NYU, Sch Med, Dept Obstet & Gynecol 251
E 33rd St New York, NY 10016 USA).. Journal of the National Cancer
Institute. 92(23):1950-1951, 2000 Dec 6. No abstract
Estrogen
deficiency: In search of symptom control and sexuality. Loprinzi, C. L. and Barton, D. Journal of the National Cancer
Institute. 92(13):1028-1029, 2000 Jul 5. No abstract
