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    ICI 182,780 (Faslodex): development of a novel, "pure" antiestrogen.

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    Authors
    Howell, Anthony
    Osborne, C Kent
    Morris, Charles
    Wakeling, Alan E
    Affiliation
    Department of Medical Oncology, Christie Hospital National Health Service Trust, Manchester, United Kingdom.
    Issue Date
    2000-08-15
    
    Metadata
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    Abstract
    BACKGROUND: The nonsteroidal antiestrogen tamoxifen is well established as an effective treatment for patients with breast carcinoma, both for the treatment of metastatic disease and as an adjuvant to surgery for patients with primary breast carcinoma. In addition to exerting antagonistic effects on the estrogen receptor, tamoxifen and its derivatives act as partial agonists on certain tissues. These agonistic effects, for example, endometrial stimulation and stimulation of tumor growth after previous response to tamoxifen, may limit their clinical efficacy. ICI 182,780 (Faslodex) from AstraZeneca (Cheshire, United Kingdom) is a novel, steroidal estrogen antagonist that was designed to be devoid of estrogen agonist activity in preclinical models. METHODS: ICI 182,780 was tested in a large number of in vitro and in vivo preclinical models, and its value was assessed clinically when administered before surgery for breast carcinoma and hysterectomy for benign conditions and after failure of tamoxifen in patients with advanced breast carcinoma. RESULTS: All data indicated that ICI 182,780 is devoid of agonist activity in preclinical models and in clinical trials. It inhibits growth of the breast and endometrium. In animal models, it does not cross the blood-brain barrier and appears to be neutral with respect to lipids and bone. ICI 182,780 down-regulates the estrogen receptor and is active in tamoxifen-resistant breast carcinoma. In a small, Phase II study, durable responses were seen: Phase III clinical trials are in progress comparing ICI 182,780 with anastrozole and tamoxifen in the treatment of patients with advanced breast carcinoma. CONCLUSIONS: ICI 182,780 specifically down-regulates the estrogen receptor and, thus, represents the first of a new class of therapeutic agents. In this report, the authors present the current evidence that distinguishes ICI 182,780 from tamoxifen and related nonsteroidal compounds and establishes ICI 182,780 as the first in a new class of therapeutic agents.
    Citation
    ICI 182,780 (Faslodex): development of a novel, "pure" antiestrogen. 2000, 89 (4):817-25 Cancer
    Journal
    Cancer
    URI
    http://hdl.handle.net/10541/86437
    DOI
    10.1002/1097-0142(20000815)89:4<817::AID-CNCR14>3.0.CO;2-6
    PubMed ID
    10951345
    Type
    Article
    Language
    en
    ISSN
    0008-543X
    ae974a485f413a2113503eed53cd6c53
    10.1002/1097-0142(20000815)89:4<817::AID-CNCR14>3.0.CO;2-6
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