Claim: Study Finds More Isn't Better for Roche Breast Cancer Drug
Verdict: SUPPORTS

Retrieved passages:
title: Study of Tamoxifen and Raloxifene
text: cancer. Study of Tamoxifen and Raloxifene The Study of Tamoxifen and Raloxifene (STAR) is a clinical trial designed determine how the drug raloxifene compares with the drug tamoxifen in reducing the incidence of breast cancer in women who are at increased risk of the disease. One of the largest breast cancer prevention studies ever, it included 22,000 women in 400 medical centers in the United States and Canada. The study concluded that raloxifene caused fewer side-effects and less endometrial cancer than tamoxifen. Raloxifene was found to be more effective at preventing noninvasive breast cancer but less effective at preventing invasive

title: Study of Tamoxifen and Raloxifene
text: Study of Tamoxifen and Raloxifene The Study of Tamoxifen and Raloxifene (STAR) is a clinical trial designed determine how the drug raloxifene compares with the drug tamoxifen in reducing the incidence of breast cancer in women who are at increased risk of the disease. One of the largest breast cancer prevention studies ever, it included 22,000 women in 400 medical centers in the United States and Canada. The study concluded that raloxifene caused fewer side-effects and less endometrial cancer than tamoxifen. Raloxifene was found to be more effective at preventing noninvasive breast cancer but less effective at preventing invasive breast

title: Bevacizumab
text: patients. This only prevented Genentech from marketing bevacizumab for breast cancer. Doctors are free to prescribe bevacizumab off label, although insurance companies are less likely to approve off-label treatments. In June 2011, an FDA panel unanimously rejected an appeal by Roche. A panel of cancer experts ruled for a second time that Avastin, the best-selling cancer drug in the world, should no longer be used in breast cancer patients, clearing the way for the U.S. government to remove its endorsement from the drug. The June 2011 meeting of the FDA's oncologic drug advisory committee was the last step in an

title: Risk factors for breast cancer
text: efficacy in preventing breast cancer compared with tamoxifen, but that there were fewer side effects with raloxifene. The RUTH Trial concluded that "benefits of raloxifene in reducing the risks of invasive breast cancer and vertebral fracture should be weighed against the increased risks of venous thromboembolism and fatal stroke". On September 14, 2007, the US Food and Drug Administration approved raloxifene (Evista) to prevent invasive breast cancer in postmenopausal women. Many xenoestrogens (industrially made estrogenic compounds) and other endocrine disruptors are potential risk factors of breast cancer. Diethylstilbestrol (DES) is a synthetic form of estrogen. It has been used between

title: Selective estrogen receptor modulator
text: to three times higher relative risk of developing endometrial cancer compared to women of an age-matched population. Toremifene, a chlorinated tamoxifen derivative, causes fewer DNA adducts in liver than seen with tamoxifen in preclinical studies and was developed to avoid hepatic carcinomas. It is used as endocrine therapy in women with ER/PR-positive stage 4 or recurrent metastatic breast cancer and has demonstrated similar efficacy compared to tamoxifen as adjuvant treatment of breast cancer and in the treatment of metastatic breast cancer. Raloxifene is used for prevention and treatment of postmenopausal osteoporosis and breast cancer prevention in high-risk postmenopausal women with

title: Cobimetinib
text: alone. Adding cobimetinib also increased the median overall survival to 25.6 months, compared to the 18 months for vemurafenib alone. Another phase III trial is comparing cobimetinib with atezolizumab and regorafenib for treament of advanced colorectal cancer. Roche has announced a planned phase III trial of atezolizumab in combination with cobimetinib and vemurafenib for BRAF-mutated melanoma. A phase II trial of cobimetinib with vemurafenib for melanoma with brain metastases was terminated in 2016. Cobimetinib in combination with paclitaxel is in a phase II trial for the treatment of metastatic triple-negative breast cancer. Cobimetinib Cobimetinib (trade name Cotellic) is a MEK

title: Women's Health Initiative
text: estrogen-plus-progestin trial, there was a sharp decrease in breast cancer risk in the early post-intervention period, though the hazard ratio remained greater than 1, followed by a sustained risk during the late post-intervention period that was significantly greater than 1. It is hypothesized that the initial decrease was due to the resulting change in the hormone environment, while the subsequent persistent increase in breast cancer incidence may be attributed to the persistence of oncogenic mutations and subsequent expansion of these mutation-harboring cell lineages. In contrast, breast cancer risk was significantly lower for the estrogen-alone group compared to placebo during the

title: Estrogen (medication)
text: This was in accordance with a previous analysis of estrogen-only treatment with estradiol or conjugated estrogens which similarly found no increased risk ( = 0.99). Moreover, another study found that the risk of breast cancer with estradiol and conjugated estrogens was not significantly different ( = 1.15 for conjugated estrogens versus estradiol). These findings are paradoxical because oophorectomy in premenopausal women and antiestrogen therapy in postmenopausal women are well-established as considerably reducing the risk of breast cancer ( = 0.208 to 0.708 for chemoprevention with antiestrogens in postmenopausal women). However, there are indications that there may be a ceiling effect

title: Risk factors for breast cancer
text: the relative risk reduction for raloxifene was 76%. The P-1 preventative study demonstrated that tamoxifen can prevent breast cancer in high-risk individuals. The relative risk reduction was up to 50% of new breast cancers, though the cancers prevented were more likely estrogen-receptor positive (this is analogous to the effect of finasteride on the prevention of prostate cancer, in which only low-grade prostate cancers were prevented). The Italian trial showed benefit from tamoxifen. Additional randomized controlled trials have been published since the guidelines. The IBIS trial found benefit from tamoxifen. In 2006, the NSABP STAR trial demonstrated that raloxifene had equal

title: Veliparib
text: trials, for advanced ovarian cancer, triple-negative breast cancer and in non-small cell lung cancer (NSCLC). In 2017, AbbVie reported that veliparib failed to improve outcomes in the triple-negative breast cancer and NSCLC trials. Veliparib Veliparib (ABT-888) is a potential anti-cancer drug acting as a PARP inhibitor. It kills cancer cells by blocking a protein called PARP, thereby preventing the repair of DNA or genetic damage in cancer cells and possibly making them more susceptible to anticancer treatments. Veliparib may make whole brain radiation treatment work more effectively against brain metastases from NSCLC. It has been shown to potentiate the effects

title: Bernadine Healy
text: a $625 million effort to study the causes, prevention, and cures of diseases that affect women at midlife and beyond. The study continues to unearth critical information, including evidence in 2002 that combined hormone replacement therapy increases the risk of invasive breast cancers by 26% and heart attack by 27% as well as an increased risk for stroke. The study's findings have resulted in a permanent 15% annual reduction in invasive estrogen positive breast cancer in post menopausal women in the U.S.; The HRT (hormone replacement) drug market in the United States simultaneously dropped by 50% to $1 billion, twelve

title: Bevacizumab
text: recommendation regarding the use of bevacizumab in the treatment of metastatic breast cancer. In 2011, the US Food and Drug Administration removed bevacizumab indication for metastatic breast cancer after concluding that the drug has not been shown to be safe and effective. The specific indication that was withdrawn was for the use of bevacizumab in metastatic breast cancer, with paclitaxel for the treatment of people who have not received chemotherapy for metastatic HER2-negative breast cancer. On Tuesday, February 14, 2012, Roche and its U.S. biotech unit Genentech announced that counterfeit Avastin had been distributed in the United States. The investigation

title: Tamoxifen
text: risk of breast cancer recurrence. Patients taking the SSRIs; Celexa (citalopram), Lexapro (escitalopram), and Luvox (fluvoxamine), did not have an increased risk of recurrence, due to their lack of competitive metabolism for the CYP2D6 enzyme. A newer study demonstrated a clearer and stronger effect from paroxetine in causing the worst outcomes. Patients treated with both paroxetine and tamoxifen have a 67% increased risk of death from breast cancer, from 24% to 91%, depending on the duration of coadministration. Recent research has shown that 7–10% of women with breast cancer may not receive the full medical benefit from taking tamoxifen due

title: Breast cancer
text: this possible risk. In breast cancer survivors, it is recommended to first consider non-hormonal options for menopausal effects, such as bisphosphonates or selective estrogen receptor modulators (SERMs) for osteoporosis, and vaginal estrogen for local symptoms. Observational studies of systemic hormone replacement therapy after breast cancer are generally reassuring. If hormone replacement is necessary after breast cancer, estrogen-only therapy or estrogen therapy with an intrauterine device with progestogen may be safer options than combined systemic therapy. Treatments are being evaluated in trials. This includes individual drugs, combinations of drugs, and surgical and radiation techniques Investigations include new types of targeted therapy,

title: Metastatic breast cancer
text: research. Several medications are in development or in phase I/II trials. Typically new medications and treatments are first tested in metastatic cancer before trials in primary cancer are attempted. Another area of research is finding combination treatments which provide higher efficacy with reduced toxicity and side effects. Experimental medications: Scheduling of drug treatments and combination treatment can have substantial impact on treatment efficacy. Nanomedicine is being studied, and there are several developments involving the targeting of cancer cells using nanoprobes. Some instances where nanoprobes are used to target specific tumor cells (based on the organ to which they have metastasized)

title: Breast cancer
text: second breast in a person who has breast cancer (contralateral risk‐reducing mastectomy or CRRM) may reduce the risk of cancer in the second breast, however, it is unclear if removing the second breast in those who have breast cancer improves survival. The selective estrogen receptor modulators (such as tamoxifen) reduce the risk of breast cancer but increase the risk of thromboembolism and endometrial cancer. There is no overall change in the risk of death. They are thus not recommended for the prevention of breast cancer in women at average risk but may be offered for those at high risk. The

title: Cancer prevention
text: Results show a continued reduction of invasive breast cancer incidence as well as a decrease in some negative side effects, including increased risk of stroke, pulmonary embolism, and deep vein thrombosis 2006 - Initial Results of the Study of Tamoxifen and Raloxifene (STAR) Released. Initial results show that postmenopausal women who are at increased risk of breast cancer can reduce their risk of developing the disease if they take the drug raloxifene 2008 - Initial results from the Selenium and Vitamin E Cancer Prevention Trial (SELECT) Released. Initial results indicate that selenium and vitamin E do not contribute to the

title: Kathleen I. Pritchard
text: had taken tamoxifen for their breast cancer and treated them with either Letrozole or a placebo. Letrozole treatment reduced the risk of breast cancer recurrence by over 40%. The study ended early because of overwhelmingly positive results. The drug also prevented metastasis of the cancer to other regions of the body. Results from this clinical study were published in "The New England Journal of Medicine" in 2003, and two years later the therapy was approved by Health Canada. Later studies suggested that extending treatment with an aromatase inhibitor like Letrozole to ten years further increases disease-free survival rates. Another study

title: Estrogen (medication)
text: significantly greater risk than less than five years ( = 1.49). In addition, sequential estrogen–progestogen treatment ( = 1.76) is associated with a lower risk increase than continuous treatment ( = 2.90), which has a comparably much higher risk. The increase in risk also differs according to the specific progestogen used. Treatment with estradiol plus medroxyprogesterone acetate ( = 1.19), norethisterone acetate ( = 1.44), levonorgestrel ( = 1.47), or a mixed progestogen subgroup ( = 1.99) were all associated with an increased risk. In a previous review, the increase in breast cancer risk was found to not be significantly

title: Breast cancer classification
text: platinum-based chemotherapy. mTOR inhibitors such as everolimus may show more effect in PIK3CA/Akt e9 mutants than in e20 mutants or wild types. DNA methylation patterns can epigenetically affect gene expression in breast cancer and may contribute to some of the observed differences between genetic subtypes. Tumors overexpressing the Wnt signaling pathway co-receptor low-density lipoprotein receptor-related protein 6 (LRP6) may represent a distinct subtype of breast cancer and a potential treatment target. Numerous clinical investigations looked at whether testing for variant genotype polymorphic alleles of several genes could predict whether or not to prescribe tamoxifen; this was based on possible differences