Tamoxifen De-Escalation in Breast Cancer
One of the things that really interested me at San Antonio in 2018 was that we saw data looking at using Tamoxifen for women with ductal carcinoma in situ or the high-risk precancerous lesions, like lobular carcinoma in situ or atypical ductal hyperplasia. And it asked the question of Tamoxifen at five milligrams versus no therapy.
And again, this was almost in a prevention sort of setting. They are DCIS patients, the atypical ductal hyperplasia patients. The standard dose of Tamoxifen has been twenty milligrams, but we know, of course, that that comes with a lot of side effects, including kind of scary side effects, like thromboembolic disease and uterine carcinoma.
So, when looking at this five milligram dose, we saw a big benefit, compared to nothing. And, I think, it gives us again an opportunity to de-escalate, where something is better than nothing. And so, those patients with stage zero ductal carcinoma in situ, may be worried about side-effects or are poorly tolerant. This gives us a real opportunity to still offer something.