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Toremifene May Protect Bones During Cancer Treatment

Men using androgen deprivation therapy for prostate cancer see improved bone mineral density

FRIDAY, Dec. 28 (HealthDay News) -- Toremifene, a second-generation selective estrogen receptor modulator, increased bone mineral density in men receiving androgen deprivation therapy for prostate cancer, suggesting that the drug may decrease fracture risk in this population, according to research published in the January issue of the Journal of Urology.

Matthew Smith, M.D., Ph.D., of Massachusetts General Hospital in Boston, and colleagues conducted an interim analysis of a phase 3 fracture prevention study of men receiving androgen deprivation therapy for prostate cancer. The patients received 80 milligrams of toremifine daily or placebo. This study evaluated the first 197 men to complete a year of follow-up.

Men in the treatment group had significant increases in bone mineral density at each evaluated site compared to placebo (lumbar spine: 1.6 percent increase versus 0.7 percent decrease; total hip: 0.7 percent increase versus 1.3 percent decrease; femoral neck: 0.2 percent increase versus 1.3 percent decrease). These changes are similar to those reported in clinical trials of raloxifene in postmenopausal women.

"Androgen deprivation therapy has other adverse effects related to suppression of testosterone and estrogen, including gynecomastia, mastodynia, vasomotor flushing, increased serum cholesterol and decreased insulin sensitivity. Consistent with their adverse metabolic effects, gonadotropin-releasing hormone agonists were recently associated with a greater risk of diabetes mellitus and cardiovascular disease. Toremifene has the potential to decrease some of these non-skeletal adverse effects of androgen deprivation therapy," the authors write.

Smith has a financial and/or other relationship with GTx, Amgen, and Novartis, and his co-authors have financial and/or other relationships with GTx and/or other pharmaceutical companies.

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