Intervention Review

Tamoxifen for relapse of ovarian cancer

  1. Chris Williams1,*,
  2. Iveta Simera2,
  3. Andrew Bryant3

Editorial Group: Cochrane Gynaecological Cancer Group

Published Online: 17 MAR 2010

Assessed as up-to-date: 1 FEB 2010

DOI: 10.1002/14651858.CD001034.pub2


How to Cite

Williams C, Simera I, Bryant A. Tamoxifen for relapse of ovarian cancer. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD001034. DOI: 10.1002/14651858.CD001034.pub2.

Author Information

  1. 1

    Royal United Hospital, Cochrane Gynaecological Cancer Review Group, Bath, UK

  2. 2

    NDORMS, University of Oxford, Centre for Statistics in Medicine, Oxford, UK

  3. 3

    Newcastle University, Institute of Health & Society, Newcastle upon Tyne, UK

*Chris Williams, Cochrane Gynaecological Cancer Review Group, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK. chrisjhwilliams@btinternet.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 MAR 2010

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Tamoxifen is an important drug for treating breast cancer. Ovarian cancer cells are known to possess receptors for hormones and may thus also respond to tamoxifen.

Objectives

Tamoxifen is used to treat breast cancer in women whose tumours have oestrogen receptors. Since ovarian cancers also commonly have oestrogen receptors, it has been suggested that tamoxifen may be of some benefit. The objective of this review was to assess the effects of tamoxifen in women with relapsed ovarian cancer.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 1, 2009. Cochrane Gynaecological Cancer Group Trials Register, MEDLINE from 2002 to April 2009, EMBASE from 2002 to April 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of review articles and contacted experts in the field, as well as drugs companies.

Selection criteria

Randomised and non-randomised studies of tamoxifen in women with ovarian cancer who have not responded to conventional chemotherapy. Only trials involving 10 or more patients were included.

Data collection and analysis

Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. No trials were found and therefore no data were analysed.

Main results

The search strategy identified 1392 unique references of which 1360 were excluded on the basis of title and abstract. The remaining 32 articles were retrieved in full, but none satisfied the inclusion criteria. Only observational data from single arm studies of women treated with tamoxifen were reported.

Authors' conclusions

We are unable to make any evidence-based recommendations as we found no comparative studies assessing the effectiveness of tamoxifen in women with recurrent ovarian cancer. There is limited evidence on anti-tumour activity from phase 2 studies, but these contain no data on the effect of tamoxifen on symptom control, QOL or the prolongation of life.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

No evidence to suggest tamoxifen benefits patients with relapsed ovarian cancer

Ovarian cancer often spreads before symptoms show. Cytotoxic drugs are often only partly effective and cause severe side-effects. The main aims of treatment for relapsed disease are symptom control and prolongation of life. No data from RCTs or non-RCTs were found, so there was no evidence that tamoxifen was effective and safe as a treatment for relapsed ovarian cancer. Laboratory studies suggest tamoxifen may be effective as a treatment for women with ovarian cancer. Although, uncontrolled non-comparative trials on patients with relapsed ovarian cancer showed tamoxifen may shrink or stabilise tumours in a small number, there is a strong need for an RCT or good quality non-randomised comparative studies to determine the effectiveness and safety of tamoxifen in terms of overall survival, tumour response, symptom control, quality of life and adverse events.