Hormonal treatment of breast cancer patients: are all antiestrogens equal?

Summary. The review presents data on clinical efficacy, complications and pharmacodynamic features of two antiestrogens — tamoxifen and toremifene. It is found that the results of tamoxifen and toremifene treatment concerning time to progression and overall survival are identical in the application of drugs for adjuvant and for palliative regimen. At the same time, toremifene as compared with tamoxifen isn’t carcinogenic (no genotoxicity) and reduces the risk of steatosis, cerebrovascular thrombosis, pulmonary embolism and deep vein thrombosis, improves bone mineral density, as well as improves the spectrum of all lipoproteins, thus reduces the risk of cardiovascular complications. Toremifene compared with tamoxifen doesn’t require individual pharmacogenomic tests for the identification of individual polymorphisms of cytochrome P450 (CYP 2D6), that is a drug with more predictable clinical effect. Prospects for the use of toremifene caused by a low incidence of side effects are associated with the long-term (10 years) and adjuvant hormonal therapy and hormonal prevention in breast cancer patients.