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Nolvadex
Clinical Pharmacology
Nolvadex
Survival was similar in the placebo and NOLVADEX groups. At 5 years from study entry, survival was 97% for both groups.
Reduction in Breast Cancer Incidence in High Risk Women:
The Breast Cancer Prevention Trial (BCPT, NSABP P-1) was a double-blind, randomized, placebo-controlled trial with a primary objective to determine whether 5 years of NOLVADEX therapy (20 mg/day) would reduce the incidence of invasive breast cancer in women at high risk for the disease (See INDICATIONS AND USAGE). Secondary objectives included an evaluation of the incidence of ischemic heart disease; the effects on the incidence of bone fractures; and other events that might be associated with the use of NOLVADEX, including: endometrial cancer, pulmonary embolus, deep vein thrombosis, stroke, and cataract formation and surgery (See WARNINGS).
The Gail Model was used to calculate predicted breast cancer risk for women who were less than 60 years of age and did not have lobular carcinoma in situ (LCIS). The following risk factors were used: age; number of first-degree female relatives with breast cancer; previous breast biopsies; presence or absence of atypical hyperplasia; nulliparity; age at first live birth; and age at menarche. A 5-year predicted risk of breast cancer of ≥ 1.67% was required for entry into the trial.
In this trial, 13,388 women of at least 35 years of age were randomized to receive either NOLVADEX or placebo for five years. The median duration of treatment was 3.5 years. As of January 31, 1998, follow-up data is available for 13,114 women. Twenty-seven percent of women randomized to placebo (1,782) and 24% of women randomized to NOLVADEX (1,596) completed 5 years of therapy. The demographic characteristics of women on the trial with follow-up data are shown in Table 2.
Table 2. Demographic Characteristics of Women in the NSABP
P-1 Trial
| Characteristic | Placebo | Tamoxifen | ||
| # | % | # | % | |
| Age (yrs.) | ||||
| 35-39 | 184 | 3 | 158 | 2 |
| 40-49 | 2,394 | 36 | 2,411 | 37 |
| 50-59 | 2,011 | 31 | 2,019 | 31 |
| 60-69 | 1,588 | 24 | 1,563 | 24 |
| ≥ 70 | 393 | 6 | 393 | 6 |
| Age at first live birth (yrs.) | ||||
| Nulliparous | 1,202 | 18 | 1,205 | 18 |
| 12-19 | 915 | 14 | 946 | 15 |
| 20-24 | 2,448 | 37 | 2,449 | 37 |
| 25-29 | 1,399 | 21 | 1,367 | 21 |
| ≥ 30 | 606 | 9 | 577 | 9 |
| Race | ||||
| White | 6,333 | 96 | 6,323 | 96 |
| Black | 109 | 2 | 103 | 2 |
| Other | 128 | 2 | 118 | 2 |
| Age at menarche | ||||
| ≥ 14 | 1,243 | 19 | 1,170 | 18 |
| 12-13 | 3,610 | 55 | 3,610 | 55 |
| ≤ 11 | 1,717 | 26 | 1,764 | 27 |
| # of first degree relatives with breast cancer | ||||
| 0 | 1,584 | 24 | 1,525 | 23 |
| 1 | 3,714 | 57 | 3,744 | 57 |
| 2+ | 1,272 | 19 | 1,275 | 20 |
| Prior Hysterectomy | ||||
| No | 4,173 | 63.5 | 4,018 | 62.4 |
| Yes | 2,397 | 36.5 | 2,464 | 37.7 |
| # of previous breast biopsies | ||||
| 0 | 2,935 | 45 | 2,923 | 45 |
| 1 | 1,833 | 28 | 1,850 | 28 |
| ≥ 2 | 1,802 | 27 | 1,771 | 27 |
| History of atypical hyperplasia in the breast | ||||
| No | 5,958 | 91 | 5,969 | 91 |
| Yes | 612 | 9 | 575 | 9 |
| History of LCIS at entry | ||||
| No | 6,165 | 94 | 6,135 | 94 |
| Yes | 405 | 6 | 409 | 6 |
| 5-year predicted breast cancer risk (%) | ||||
| ≤ 2.00 | 1,646 | 25 | 1,626 | 25 |
| 2.01-3.00 | 2,028 | 31 | 2,057 | 31 |
| 3.01-5.00 | 1,787 | 27 | 1,707 | 26 |
| ≥ 5.01 | 1,109 | 17 | 1,162 | 18 |
| Total | 6,570 | 100.0 | 6,544 | 100.0 |
Generic Name: Tamoxifen Citrate
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