Raloxifine/tamox

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aspiringmd1015

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Tamoxifine is used in the treatment of estrogen dependent breast cancer, and it says raloxifine is used in the prevention. Can ralox also be used in the treatment? or is it only for prophylactic use
 
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Tamoxifen is an antagonist on the breast and agonist on the bone. It's side effect is endometrial hyperplasia.

Raloxifine has the same MOA, but does not have the side effect of endometrial hyperplasia. Hence the term "relax" when you use it.
 
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right, but thats not what i was asking, i was wondering why UW specifically states ralox can be used for prophylactic purposes of breast Ca, and tamox can be used to treat breast ca.
 
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Based on the STAR Trial:

Tamoxifen is approved for the prevention and treatment of breast cancer.

Raloxifene is approved for the prevention and treatment of osteoporosis as well as the prevention of breast cancer.
 
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awesome thanks. btw instead of making a new thread, where should i read acid base from? i tried kaplan lectures but didnt get a good grasp on it. i heard costanzo physio?
 
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Sorry my last post wasn't specific enough to your question.
aspiringmd1015 said:
awesome thanks. btw instead of making a new thread, where should i read acid base from? i tried kaplan lectures but didnt get a good grasp on it. i heard costanzo physio?
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Whatever you read it from, just makes your know CO2 is an acid, know it's normal value (33-45), and that it changes immediately. Also know the bicarb will drop after 48 hours in metabolic acidosis, and its normal value (22-28 w/ an average of 24). It will help you figure things out very quickly just by knowing those 2 lines.
 
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On the same topic just to confirm i got this right.

Er+ pr- = tamoxifen/raloxifen (raloxifen is better?). If post menopausal aromatase inhibitor

Er+ pr + same as above

Er- pr+ ?? Same as above

Her2neu positive er- pr- - herceptin

Her2neu positive er+ pr + - herceptin is best??
 
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In practice they use tamoxifen if either of the hormone receptors are positive, and if HER2 is + with anything else they use herceptin. This can change of course with stage, a t1n0m0 with negative margins who has lumpectomy+rad or mastectomy might elect not to or whatever but for the purpose of our boards I think if they present one as being positive for those receptors you can use those drugs.

As for tamoxifen vs raloxifene according to the STAR trial tamoxifen was more effective in preventing breast cancer of different types at 7 years (raloxifene was 78% as effective) but was better at preventing uterine cancer (makes sense considering mech). Both groups had very similar risks of fracture interestingly. In clinic I have not seen raloxifene used as much as tamoxifen. But someone else could weigh in better on that probably although I don't think it's a nuance we would really be tested on.


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ah thanks. Still unsure about the ER - and PR + one? Not exactly sure how tamoxifen would help there but I think i remember seeing a question where the answer was to give it?
 
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Honestly not sure the mech of that either, maybe there is some dual actual. I know they def use it for PR + ER - tumors tho


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