Hormonal or endocrine therapy can be used to treat metastatic, hormone-receptor-positive breast cancer. Since the early 1970s, the ER antagonist, tamoxifen has been used to inhibit or suppress tumour growth (20). The selective oestrogen receptor modulator (SERM) works by preventing the binding of oestrogen to oestrogen receptors located in the breast tissue (20). In order to exhibit its antagonistic effects, it undergoes metabolism by cytochrome P450 enzymes and converted into its active and inactive metabolites (Figure 4) (20). The active metabolites of tamoxifen are N-desmethyltamoxifen, which can be converted to endoxifen by CYP2D6, as well as 4-hydroxyltamoxifen (Figure 4) (20). Consequently, the affinity of these active metabolites to the ER is increased by ten-fold compared to its parent compound (20).
Figure 4: The main enzymatic pathways of tamoxifen metabolism (20).
The Early Breast Cancer Trialist’ Collaborative Group (EBCTCG) conducted a meta-analysis of 20 randomised trials that examined the efficacy of tamoxifen use in early breast cancer patients (21). The trial participants were allocated (1:1) into either receiving five years of adjuvant tamoxifen or control. The patients with ER-positive tumours receiving tamoxifen
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Following the results from this trial, 46 HPBC patients were recruited by Baselga et al. (1999) to examine the safety and efficacy of weekly administration of trastuzumab (26). An overall response rate of 11.6% with one complete and four partial remissions were observed (26). As previous findings showed, treatment with trastuzumab was well-tolerated with minimal signs of toxicity (26). Similarly, the results from Vogel et al. (2002) confirm this as demonstrated by the response rate of 26% with seven complete and 23 partial remissions in 114 women with HER2-overexpressing metastatic breast cancer
Aetna, Inc. was established in 1853 and offers health insurance options for purchase. The main product portfolios include health insurance products with medical, dental, pharmacy, behavioral health, group life and disability plans. This essay will analyze the company’s structure and environment and provide recommendations on strategies that the company could take to improve performance.
There has been conflicting research and advice about the safety of hormones with the increase in the aging female population within the last twenty years (National Institute on Aging). Hormone therapy has demonstrated to be the most effective FDA approved medication in the relief of menopausal symptoms, but these benefits must be weighed against serious adverse effects that hormones can cause. Although many women differ in their response to hormone products, MHT has been universally linked to an increased risk of heart disease, heart attack, blood clots, and strokes. Concerns about the findings discovered in the clinical and observation trials performed on MHT, have left some doctors and women hesitant in utilizing MHT to combat menopausal symptoms.
Breast cancer is most commonly diagnosed in Stage I and Stage II, where the size of the tumor is less than five centimeters in diameter. In these situations, surgery is often the second treatment option after chemotherapy and radiation therapy, both of which are used to shrink the tumor to a manageable size first. If the patient chooses to, the ...
Chemoprevention requires treatments that are administered to presumably healthy, asymptomatic subjects who do not have cancer, but do have risk factors associated with an increased probability to cultivate the cancer which the experimental intervention is theorized to condense. So, chemoprevention research involves at-risk research subjects who are neither patients diagnosed with disease, as in treatment trials, or typical healthy volunteers. There is a growing interest and investment in research on cancer chemoprevention. Several major cancer chemoprevention trials have been conducted in the United States, including trials testing the effectiveness of tamoxifen, both alone and later compared to raloxitene, to prevent primary invasive breast cancer; finasteride to prevent prostate cancer; and beta-carotene to prevent lung cancer.
In 1896 the scientist Beatson reported that the removal of the ovaries resulted in the reduction of breast cancer tumours (Russo and Irma 1998). Breast cancer is a malignant, metastasizing cancer of the mammary gland. It is the leading cause of death in woman between the ages of 35 - 45. Breast cancer can also occur in males, although less frequent, around 400 men die each year from breast cancer in the united states. (Martini, F., 2004). Studies on rats have shown considerable evidence that rat oestrogens are mammary carcinogens. Oestrogens have shown to stimulate the hormone prolactin. Through studies involving the use of antioestrogens, for example, tamoxifen, "Tamoxifen alone or in combination with the retina all trans-N-(4 hydroxyphenyl)-retinamide (4-HPR) reduces the incidence of NMU-induced mammary tumours in Sprague-Dawley rats." (Jane M. Ussher Ph.D. 1996). This suggests that Oestrogens and Prolactin's can have the effect of the development of breast cancer since the pathogenesis of spontaneous breast cancer in humans is similar to that of chemical-induced rodent mammary cancer. (Jane M. Ussher
...ars to be the most promising agent in primary prevention of breast cancer. It changed the way prevention is perceived by biomedicalizing it. Prevention is seen as equivalent to risk reduction. Also, it is the only United States Food and Drug Administration (US FDA) approved drug for reducing breast cancer risk in high-risk women. Promising as it may seem, the scope of primary prevention has been restricted to women at high risk of developing breast cancer because of inherent limitations of these strategies. Knowledge is power, “The lack of knowledge in the realm of breast cancer prevention makes for greater investment in chemoprevention”. Owing to failure of etiologic studies in breast cancer research to identify primary prevention strategies suitable for the general population, reducing mortality through early detection of breast cancer still remains the mainstay.
There are many different approaches for management of breast cancer and treatment options that patients may select in collaboration with health care providers. Breast cancer is a complex disease that presents in many different types, with specific biological features unique to each patient. Invasive cancers are classified based on tumor type and histological grade, which is of utmost importance when deciding the course of treatment. Contemporary advances in breast cancer treatments have been made, especially in chemotherapy, hormone and biological therapies. Treatment can be a combination of local treatments, systemic treatments, and in some cases, new targeted treatments (Watts, 2013).
Breast Cancer is defined as “a group of solid tumor malignancies arising in the tissues of the breast” (Sarah Crawford, Richard Alder, 2013) in human and other mammals. It can happen to both men and women. For women, breast cancer is one of the leading causes of cancer death. According to National Cancer Institute, in the United States, the 2014 estimated new cases and deaths of female from breast cancer are 232,670 and 40,000, respectively. For male, it’s 430 deaths out of 2,360 new cases. From these numbers, we can see that women in the U.S. are greatly affected by breast cancer, thus, it’s not difficult to imagine the impact on a worldwide level. Although these numbers look frightening, people can actually survive from breast cancer if it is detected early and treated properly, so it is extremely important for all of us, especially women, to have a better understanding of breast cancer.
Over the years, the fight against ovarian cancer has proven to be even more difficult due to the cancer being asymptomatic at its early stages. For this reason, there are constantly late diagnoses made on women who unfortunately develop this cancer (Stack).... ... middle of paper ... ...
Merck & Co. has to be aware of the economy as with any industry. Within the recession, more and more were looking towards generic substitutes. This can at times not be a problem with patents. However, once a patent is up, a competitor who develops generic versions of Merck’s products becomes a low-cost competitor. However, during the recession from 2008 – 2009, Merck didn’t see any drop in sales. Actually, they were able to keep a continual increase in sales and net income.
With the increased cost of manufacturing, pharmaceutical companies have been divesting in their smaller or less profit making operations and focus on large segments. Many Pharmaceutical companies sold their manufacturing sites to contract manufacturing organizations. The dynamics of interfacing with contract manufacturing organization added intricacy in pharmaceutical supply chain network of pharmaceutical companies.
The case under analysis, Eli Lilly & Company, will be covering the positives and negatives with regards to the business situation and strategy of Eli Lilly. One of the major pharmaceutical and health care companies in its industry, Lilly focused its efforts on the areas of "drug research, development, and marketed to the following areas: neuroscience, endocrinology, oncology, cardiovascular disease, and women's health." Having made a strong comeback in the 1990's due to its remarkably successful antidepressant Prozac, was now facing a potential loss in profits with its patent soon to expire. The problem was not only the soon to expire patent on Prozac, but the fact that Prozac accounted for as much as 30% of total revenue was the reality Eli Lilly now faced. (Pearce & Robinson, 34-1)
Historically speaking breast cancer has been around for hundreds of years. Thankfully the treatment has improved. Patients who get the cancer removed and take care of themselves after, for example, by exercising and eating healthy, will live longer. There are many risks that increase the likelihood of developing breast cancer, for instance, age, family history, and race. A women who made history with breast cancer was Betty Ford, Betty was one of the first lady’s to speak openly about her disease. Betty encouraged women who have been affected with the disease to go to their doctor as soon as possible and told women who had shared that they didn’t have breast cancer to do self breast exams regularly and get mammograms. She also said when women get diagnosed with it don’t be embarrassed. Treatments in the past were pretty good and quite the same compared to the treatments given to people now, for instance, mastectomy’s which was the primary...
A research was held for young and older women. Two drugs were administered to treat breast cancer. Epirubicin and gemcitabine are two chemotherapy drugs used on the patients. The research came back with astonishing results. The Young and older women had a positive reaction to the drugs. Dr. Feher’s research shows the drug to be safe enough for young women and the older generation to treat breast cancer (Dockter & Keene, 2009).
The United States has long been a leader in scientific research, but it will take industry, academia, and government working together for our country to stay there. Since the implementation of the Bayh-Dole Act of 1980, which gave universities greater control over intellectual property, research universities have teamed up with partners during early-stage development to further their resources. The new task of universities was not to conduct research with the intent to make money, but to present their findings to the public domain for the sake of knowledge and the public good. In 2004, David Sinclair and Christopher Westphal, two innovative scientists following their intuition, founded Sirtris Pharmaceuticals. The founding idea arose from Sinclair’s