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Evista as adjuvant therapy

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Last Modified: January 14, 2008

Dear OncoLink "Ask The Experts,"
Can Evista (Raloxifene) be used as a substitute if someone cannot tolerate Tamoxifen for treatment after breast cancer?

Angela DeMichele, M.D., MSCE, Assistant Professor of Medicine and Epidemiology at the University of Pennsylvania and Senior Scholar in the Center for Clinical Epidemiology and Biostatistics, responds:

Evista (Raloxifene) is not an option for adjuvant treatment of breast cancer (which is where tamoxifen is used). It is indicated for the treatment or prevention of osteoporosis, and it is currently being studied in breast cancer prevention. A large study was recently completed and suggests that it might also reduce the risk of endometrial cancer.

However, despite the fact that raloxifene is in the same class of medications as tamoxifen (a selective estrogen receptor modulator, or SERM), it has not been studied very well as a breast cancer treatment. Therefore, there is no data for its effectiveness as adjuvant therapy after a breast cancer diagnosis. The only adjuvant hormonal treatments approved right now are tamoxifen and aromatase inhibitors (letrozole, exemestane, anastrazole).