Review: Patient-controlled transdermal 4-hydroxytamoxifen (4-OHT) vs. oral tamoxifen: A systematic review and meta analysis.

Abstract

There has been a number of studies looking into an alternative mode of therapy for the treament of breast cancer via 4-hydroxytamoxifen (4-OHT) transdermal administration.This systematic review aims to compare the safety and efficacy of a transdermal 4-OHT local therapy and oral tamoxifen (oral-T) on the treatment of ductal carcinoma in situ breast cancer. Through a systematic search of health science databases, eligible trials were located and the end points assessed were Ki-67 labeling index, concentration of 4-OHT in breast adipose tissue (ng/g) and plasma (ng/ml). Revman 5.3 version was used to perfom the meta-analysis. Three trials were identified (n=103), while only two were included for meta analysis. The mean difference between the two studies included were 0.40 and -10.58. Overall the I2 value was 89.0%, (Tau2 =53.86) and the differences between the two trials were statistically significant p=0.002. The meta analysis of the randomized controlled trials showed that the use of local transdermal therapy of 4-OHT gel is more safer than oral-T. However, due to the limited number of studies, the potential use of 4-OHT topical transdermal therapy for the treatment of breast cancer could not be concluded for healthcare professionals.

• Authors: Usha Sundralingam, Tahir Mehmood Khan, Sumita Elendran, Saravanan Muniyandy, Uma D Palanisamy
• Journal: Pakistan journal of pharmaceutical sciences (Pak J Pharm Sci) Vol. 32 Issue 3 Pg. 1121-1128 (May 2019) ISSN: 1011-601X [Print] Pakistan
• PMID: 31278729 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Antineoplastic Agents
• Tamoxifen
• afimoxifene

Topics

• Administration, Cutaneous
• Administration, Oral
• Antineoplastic Agents (administration & dosage, pharmacokinetics)
• Breast Neoplasms (drug therapy)
• Carcinoma, Intraductal, Noninfiltrating (drug therapy)
• Female
• Humans
• Randomized Controlled Trials as Topic
• Tamoxifen (administration & dosage, analogs & derivatives, pharmacokinetics, pharmacology)