CN1879623A - Methods of preventing breast cancer - Google Patents

Abstract

The use of a compound of Formula I as a medicine for postclimacteric women to prevent breast cancer and its orally taken effective dosage are disclosed, and the dosage is 55-65 mg/day. The medicine composite is also disclosed, each dosage unit of which includes the hydrochloride of the compound of Formula I in 60-120 mg and pharmaceutically acceptable excipient, diluent or carrier.

Description

The prevention method of breast carcinoma

The application be that October 30, application number in 1997 are 97122526.5 the applying date, denomination of invention divides an application for the application for a patent for invention of " prevention method of breast carcinoma ".

Technical field

Breast carcinoma is the thirty year of women from life, lasts till an old and feeble main difficult medical problem always.Estimate at present in the U.S., the women its in life (until 80 years old) have eighth chance to develop into this disease, and 20 eighth women have the danger (Harris et.al., Ed.Diseases of the Breast, 1996: the 159-168 pages or leaves) of the breast carcinoma died from life.Breast carcinoma is the third-largest common cancer, also is modal cancer among the women.It is women's main causes of death, also is the reason of invalidity, psychic trauma and economic loss.Breast carcinoma be the American Women cancer mortality second largest common cause (Forbes, Seminars inOncology, vol.24 (1), Suppl 1,1997: the S1-20-S2-35 page or leaf).This sick indirect action also promotes the death from breast carcinoma, comprises such as the result who is transferred to disease progressions such as bone or brain.Interfere the side effect of (intervention) (such as operation, X-ray therapy, chemotherapy or bone marrow transplantation etc.) also to promote by complication, radioactive fibrosis and neutrophilic granulocyte shortage property sepsis, therapeutic that bone marrow depression produces from this sick M ﹠ M.

Background technology

Although it is, still very poor to the EPDML understanding of this disease through a large amount of research.As if a genetic constitution is arranged, make some women be partial to infect this disease.Not clear this genetic constitution is this sick cause of disease or permisssive, still is the omen of lysis.Although known for a long time breast carcinoma is tended to occur in more continually in some family, this alanysis not always the group member of other family the omen of disease takes place, very little for the popular value of prediction in general groups.Estimate to have only in all breast carcinoma 5% at present by genetic factor generation (Harris et.al., Ed.Diseases of the Breast, 1996: the 159-168 pages or leaves).

Now carried out vast amount of clinical and pharmaceutical research, with attempt to set forth the cause of disease of hormone-estrogen and breast carcinoma and keep between relation.The risk factor of disease is mainly relevant with the cumulative estrogen exposure of women, comprising: age and age of meuopause when the age of menophania, parity, full-term pregnancy for the first time.Although known many keep about disease in the importance of estrogen-dependent of estrogenic relation and disease endocrine therapy, but to estrogenic effect in this disease pathogeny (promptly in oncogenic process, estrogen is the cause of disease (initiator), still limited co-factor (promoter)) sizable arguement arranged.

Estrogen comprises 17-, estrone and their active metabolite, be the major hormone relevant with property in the human female, but it is grown up at masculinity and femininity and lives in addition, seemingly an important homeostatic hormone.Everyone has certain density endogenous estrogen.Yet most of people do not develop into breast carcinoma, and this supports a kind of like this view: estrogen itself is not the carcinogenic initiator such as chemical carcinogen or environmental carcinogen etc.In addition, the women is not because when the forfeiture that the endogenous ovarioestrogen generates and menopause, the danger that they infect this disease correspondingly reduces.In fact, except that individual breast carcinoma medical history, the age is the risk factor that a maximum of this disease takes place.Breast carcinoma is rare in less than 20 years old women, but should danger increase sharply along with the increase at age.Compare with the danger that breast carcinoma takes place for 20 years old women, the women's in 40-49 year danger increases by 40 times, the women in 50-59 year increases by 60 times, and the danger of the women more than 60 years old is than she dangerous high 90 times (Forbes at an early age, Seminars inOncology, vol.24 (1), Suppl 1,1997: the S1-2-S1-35 page or leaf).

Hormone replacement treatment (HRT) recommends to be used for the women in postmenopausal women and menopause usually, alleviating the symptom of menopause, and reduces the danger of long-term insufficient other the serious sequela of cardiovascular disease, osteoporosis and estrogen.Yet, because generally accepted, about the direct acting evidence of all one's life contact of cumulative estrogen and breast cancer risk, hormone replacement is increased the women probability of breast cancer risk takes place heated argument is arranged.Although the danger of short-term HRT (being less than 5 years) is very little or be safe from danger, but having reported the danger that breast carcinoma takes place, the epidemiological study of life-time service HRT (5-7) and meta-analyses increase 35-75% (Grady et.al., Hormone Therapy to Prevent Disease and Prolong Life in PostmenopausalWomen., Ann Intern Med, 117: the 1016-1037 pages or leaves, 1992).

The theory and the evidence that act in this disease pathogeny about estrogen are complicated.The test model of breast carcinoma in rat need give carcinogen, and with induced tumor (tumor generation), and estrogen plays promoter (not being inducing agent) in this process.In these animal models, ovariectomy is disturbed the carcinogenic process of chemical induction.Yet in the mankind, do not know carcinogenic opportunity.Be known that, compare with the women of 50 years old natural menopause, premature menopause or before 40 years old, be the ovariectomized women of surgery through medical treatment, the danger of its breast carcinoma reduces about 50% (Harris et.al., Ed.Diseases of the Breast, 1996: the 159-168 pages or leaves).Therefore, the prevention method of breast carcinoma aiming minimizing estrogen contact in life is rational.By giving a kind of medicament, along the estrogenic generation of blocking-up Anywhere and/or the effect of hypothalamus-hypophysis cerebri-gonadal axis, carry out the inductive estrogen deficiency of pharmacology, can accomplish this point.Yet inferring may the success or not ambigendi locus with the medicament Breast Cancer Prevention of this character.

Opposite with the complexing action of estrogen in this disease pathogeny, although continue to draw many data, we are confirming to have obtained sizable progress aspect the effect of estrogen in breast carcinoma forms.Estrogen is the somatomedin of the early stage most of breast cancer cells of this disease.Quick splitted cell is by estrogen receptor and to its effect sensitivity.Although do not understand well, also confirm, when certain in this disease process is a bit, transforms (cancer) cell and lose their sensitivity usually the estrogen facilitation.At last, the growth of most of cancerous cell becomes and does not rely on estrogen, and loses them to replying based on hormone therapy (comprising: GNRH gaonist, " estrogen antagonist ", progestogen and androgen).

Along with based on the therapeutic interventional appearance of hormone and use widely, many benefits in breast cancer treatment, have been obtained.The most widely used hormone therapy is a tamoxifen.5 years survival rates of the women that suffers from breast cancer have been improved with this therapy the earth to the utmost; Yet the continuation treatment that surpasses 5 years does not obtain extra benefit or survival advantage.In fact, data show goes out, and the use of tamoxifen surpasses 5 years, and disease free survival rate and total survival rate reduce (NSABP B-14 test; Fisher et.al., Five Versus More Than Five Years of Tamoxifen Therapy forBreast Cancer Patients With Negative Lymph Nodes and EstrogenReceptor-Positive Tumors, J Natl Canc Inst, vol.88 (21): 1529-1542 page or leaf, 1996).Unfortunately, tamoxifen also is accompanied by tangible negative interaction, such as: obviously increase the sickness rate of venous thromboembolism, actual sickness rate (16-67%), formation cataract and the formation DNA-adduct etc. that increase vasomotor symptoms or hot flush (hot flashes), although the latter does not have clinical confirmation, but still increased suffering from the worry of hepatocarcinoma (in animal model test, observing) probability.Yet the most serious thing is the estrogen action of tamoxifen in the uterus, it causes endometrial hyperplasia, and in fact increase sickness rate (take tamoxifen after 5 years danger increased 3-4 doubly) (the Goldhirsch et.al. of carcinoma of endometrium, Endocrine Therapies ofBreast Cancer, Sem in Onc, vol.23 (4), 494-505 page or leaf, 1996).For this reason, and owing to lack the survival advantage that improves the life-time service tamoxifen, therefore, the present tamoxifen treatment of avoiding more than 5 years.

Data suggest, because long-term contact tamoxifen, change has taken place in breast tumor cell, make them produce drug resistance to its estrogenic antagonist, perhaps changed the (Santen that replys to its estrogen performance, Editorial:Long Term Tamoxifen Therapy:Can an Antagonistbecome an agonist?, J Clin Endo ﹠amp; Metab, vol.81 (6), 2027-2029 page or leaf, 1996).The variation of any step in estrogen receptor information approach all may be the main cause that produces tamoxifen treatment mechanism of drug resistance, some of them do not cause the cross resistance to other hormone therapy, and some of them cause the hormone therapy of any kind is not all replied fully really.The chemical sproof mechanism of tamoxifen is gradually transformed into not dependency (the estrogen receptor positive cell becomes estrogen receptor negative) of estrogen owing to cancerous cell from estrogen-dependent.Even with the combination (operation, radiotherapy and/or chemotherapy) of available state-of-the-art therapeutic modality, patient's long-term prognosis is also very poor, and is especially all the more so when having metastatic disease therefore.Very clear, be starved of and improve treatment, the most important thing is that perhaps key need be prevented this disease (from the beginning or initial stage prevention) at the very start.

Although broad research tamoxifen, and proof is effectively to the disease of determining, also do not have complete, clinical trial large-scale, that the placebo of expection is arranged that the possible purposes of this chemical compound in the prevention of breast carcinoma initial stage is described.Studies show that, the women who cancer history is arranged in a mammary gland and treat with tamoxifen, the sickness rate of offside breast tumor reduces.Although this can be interpreted as one type prevention of this disease, do not know that this is the metastasis effect or from the beginning suppresses this disease.Attempting not have aspect from the beginning prevent disease is brought out in the healthy women of special medical history or breast cancer risk factor, this difference of understanding in the biological mechanism is very important.

Just should study " estrogen antagonist " treatment in the past ten years always, especially use the probability of former (de novo) breast carcinoma of tamoxifen prevention to argue.Yet part is owing to lack the evidence of benefit and because the known and potential toxicity of tamoxifen, the prophylactic tria of expection is not arranged also in healthy women.Recently, proposed two prophylactic trias of this class, each test all is the exercise question of in fact arguing.As a result, the test that will carry out in Britain is considered to have inappropriate danger and benefit ratio, and is not carried out.In Italy, require the Prevention Research of tamoxifen only in the women who carries out uterectomy, to carry out equally for the security concerns that carcinoma of endometrium takes place.Yet in the U.S., this test is carried out under the patronage of National Cancer Institute.Owing to recognize that this class analysis of experiments is disputable, yet but need a large amount of samples, thereby the test of the U.S. only limits to have highly dangerous and develops into this sick women, comprises before the menopause and postmenopausal women's (assessment of risks of young woman must be equivalent to 60 years old women's qualified research of dangerous).This result of the test can not obtain in 3 years at least.(may be used as the arguement of the chemopreventive agent of breast carcinoma about tamoxifen, the further data of clinical design and the definition of high-risk probability, referring to: " Breast Cancer Prevention Study:Are HealthyWomen Put at Risk by Federally Funded Reserach? " Transcript of theHearing Before the Human Resources and Intergovermental RelationsSubcommittee of the Committee on Govermental Operations, House ofRepresentatives of the One Hundred Second Congress, Second Session, October 22,1992[ISBN-0-16-044316-4], this paper incorporated by reference document and evidence).

Because the purpose of disease prevention is to shield women to avoid canceration process (or infringement pre-cancer takes place) and developed into invasive disease (cancer) afterwards, the use that prolongs the prophylactic treatment medicament is essential (Kelloff et.al., Approaches to the Development and MarketingApproval of Drugs that Prevent Cancer, Cancer Epidemiology, Biomarkers﹠amp; Prevention, vol.4,1-10 page or leaf, 1995).This will need the toleration of this treatment very good, the outstanding and side effect minimum of safety.Raloxifene (raloxfene) is studied in 12,000 experimenters.From prevention or the clinical trial of the osteoporotic III of treatment postmenopausal women phase raloxifene, a large amount of synthetic data have been analyzed to study its safety.During comprehensive all dosage of raloxifene, this analysis has comprised the patient who is contacted with raloxifene for many years more than 12,850.On the clinical experience basis in nearly 3 years, proved that the toleration of raloxifene is very good, have very wide therapeutic index, evidence acute or chronic toxicity is minimum.By contrast, the negative interaction that the life-time service tamoxifen is followed obviously increases people to its worry (Grainger et.al., Tamoxifen:Teaching an old DrugNew Tricks as the chemopreventive agent fitness, Nat Med, vol, 2 (4), the 381-385 page or leaf, 1996).

The from the beginning prophylactic treatment that does not also prove breast carcinoma so far is effective.And, there not being catastrophe risk to develop among the women of general groups of breast carcinoma, do not carry out or plan to carry out the research of Breast Cancer Prevention.Very clear, be starved of and can be used for the general groups breast carcinoma prophylactic treatment of (individual who comprises high-risk also comprises the individual who does not have special high-risk, comprises masculinity and femininity).

Summary of the invention

The invention provides the Breast Cancer Prevention method of (comprising from the beginning Breast Cancer Prevention).

The present invention relates to prevent the method for human breast cancer, this method was included in enough time limits, gave formula (I) chemical compound or its pharmaceutically acceptable salt or the solvate of described human effective dose.

The invention still further relates to the production product that comprises packaging material and be contained in the medicament in the described packaging material; Packaging material comprise a sign, and demonstration can be taken medicament with Breast Cancer Prevention, and medicament is formula I chemical compound or its pharmaceutically acceptable salt or solvate.

Description of drawings

Fig. 1 has described in the research that placebo is arranged, and the percentage ratio of breast carcinoma takes place in the patient that the patient and the raloxifene of placebo treatment are treated.

The present invention relates to a discovery, promptly formula I chemical compound can be used to Breast Cancer Prevention.By raloxifene or its pharmaceutically acceptable salt or the solvate of the people's doses that needs were arranged in enough time limits, implement method provided by the invention, can effectively prevent breast carcinoma.

The term " prevention " that uses with breast carcinoma comprises the probability that reduces human generation or develop into breast carcinoma.This term does not comprise that treatment is diagnosed as the patient of breast carcinoma.

Be used for term of the present invention " former " and be meant that the normal breast cell does not transform at the beginning or metamorphosis is cancerous cell or malignant cell.This conversion may be passed through evolutionary process, occurs in same cell or daughter cell in the stage, maybe may occur in a crucial moment.This former process is to be different from transfer, to move and give birth to or cell transformed or malignant cell have been diffused into reposition from initial knub position process." former " is relevant with the initial stage prevention.The present invention also relates to give former or secondary with formula I chemical compound is the higher patient of breast cancer risk.

The people who does not have catastrophe risk to develop into breast carcinoma is the people that possible develop into former suppurative mastitis adenocarcinoma, does not have evidence or suspects that this sick probability is higher than normal danger, and never diagnosing out has this sick people.Promoting that the risk factor of the maximum of breast cancer development is the personal history of breast carcinoma, even should disease more than 5 years or 5 years when a human therapy, be considered to " breast carcinoma survivor ", also is like this when not having the evidence of residual disease.Another generally accepted risk factor is this sick family history.

Raloxifene is the hydrochlorate of formula I chemical compound, has shown with estrogen receptor to combine, and thinks that at first its function and pharmacology go up the molecule for " estrogen antagonist ".In fact, raloxifene is blocked the effect of estrogen in some tissue really; Yet in other tissue, for example in skeleton and in blood fat, raloxifene activates the gene identical with estrogen, shows similar pharmacological property, plays estrogen agonists.Think now, because raloxifene-estrogen receptor complex is unique to the activation and/or the inhibition of range gene function, opposite with the gene activation and/or the inhibition of estrogen-estrogen receptor complex, cause that raloxifene shows unique effect, and be different from estrogen.Therefore, although raloxifene and estrogen utilization and competing phase receptor together, the pharmacology result of difficult these two chemical compound Gene regulation of prediction, each chemical compound all is unique.

Usually prepare this chemical compound with general excipient, diluent or carrier, and be pressed into tablet or be formulated as and be convenient to oral elixir or solution or by intramuscular or intravenous administration.These chemical compounds can transdermal or intravaginal administration, can be mixed with sustained release formulation, parenteral form, depo form etc.

The chemical compound that is used for the inventive method can prepare in accordance with known methods, and these methods are such as at United States Patent (USP) 4,133,814,4,418,068,4,380,635,5, on March 3rd, 629,425,1996 disclosed UK Patent Application GB 2,293,602 and February 28 nineteen ninety-five application and in the nineteen ninety-five method described in detail in the disclosed european patent application 95301291 in 6th of JIUYUE etc., all be attached among the present invention as a reference at this.In general, this method is begun by benzo [b] thiophene with 6-hydroxyl and 2-(4-hydroxyphenyl).The hydroxyl of protection raw material, acidylate on its 3 makes product go protection then, forms formula I chemical compound.The example of this compounds preparation is provided in above-mentioned United States Patent (USP) and Britain's application.

Be used for chemical compound of the inventive method and the addition salts that multiple organic and inorganic bronsted lowry acids and bases bronsted lowry generates pharmaceutically acceptable soda acid; Comprise that the physiology who is generally used in the pharmaceutical chemistry goes up acceptable salt.This class salt also is a part of the present invention.The typical inorganic acid that is used to generate this class salt comprises hydrochloric acid, hydrobromic acid, hydroiodic acid, nitric acid, sulphuric acid, phosphoric acid, hypophosphoric acid etc.Also can use by the deutero-salt of following organic acid: the alkanoic acid, hydroxyl alkanoic acid and hydroxyl chain docosandioic acid, aromatic acid, aliphatic series and the aromatic sulfonic acid etc. that replace such as mono carboxylic acid of aliphatic series and dicarboxylic acids, phenyl.Therefore this class pharmaceutically acceptable salt comprises acetate; phenylacetate; trifluoroacetate; acrylates; ascorbic acid; benzoate; chloro benzoate; dinitro-benzoate; hydroxy benzoate; methoxybenzoic acid salt; ar-Toluic acid salt; adjacent acetylbenzoic acid salt; naphthalene-2-benzoate; hydrobromate; isobutyrate; phenylbutyric acid salt; beta-hydroxy-butanoic acid salt; butine-1; the 4-diacid salt; hexin-1, the 4-diacid salt; caprate; caprylate; hydrochlorate; cinnamate; citrate; formates; fumarate; oxyacetate; enanthate; hippurate; lactate; malate; maleate; hydroxymaleic acid salt; malonate; mandelate; mesylate; nicotinate; .gamma.-pyridinecarboxylic acid salt; nitrate; oxalates; phthalate; terephthalate; phosphate; dibasic alkaliine; dihydric phosphate; metaphosphate; pyrophosphate; propiolate; propionate; phenpropionate; Salicylate; sebacate; succinate; suberate; sulfate; bisulfate; pyrosulfate; sulphite; acid sulphite; sulfonate; benzene sulfonate; brosylate; closilate; esilate; the 2-isethionate; mesylate; naphthalene-1-sulfonate; naphthalene-2-sulfonic acid salt; tosilate; xylenesulfonate; tartrate etc.Preferred salt is hydrochlorate.

Usually with formula I chemical compound with wait mole or excessive acid reaction, generate pharmaceutically-acceptable acid addition.Reactant mixes in such as mutual solvents such as ether or benzene usually.Salt was settled out in 10 days at 1 hour usually, can pass through isolated by filtration, maybe can remove with conventional method and desolvate.

Be commonly used to give birth to salifiable alkali and comprise ammonium hydroxide and alkali metal and alkaline earth metal hydroxide, carbonate and aliphatic monoamine, diamine and tertiary amine, aliphatic diamine.The alkali that is particularly useful in the addition salts preparation comprises sodium hydroxide, potassium hydroxide, ammonium hydroxide, potassium carbonate, methylamine, diethyl ammonium, ethylenediamine and cyclohexylamine.

Pharmaceutically acceptable salt is compared with their those chemical compounds of deriving, and generally has higher dissolubility property, therefore is easier to be formulated as liquid or suspension usually.

Pharmaceutical preparation can prepare with methods known in the art.For example, excipient, diluent or carrier preparation chemical compound be can use, tablet, capsule, suspension, powder etc. formed.The example that is suitable for excipient, diluent and the carrier of this class preparation comprises following material: filler and extender, such as starch, sugar, mannitol and silica derivative etc.; Binding agent is such as carboxymethyl cellulose and other cellulose derivative, alginate, gelatin and polyvinylpyrrolidone etc.; Wetting agent is such as glycerol etc.; Disintegrating agent is such as calcium carbonate and sodium bicarbonate etc.; Postpone dissolved reagent, such as paraffin etc.; Absorption enhancer is such as quaternary ammonium compound etc.; Surfactant is such as spermol, glyceryl monostearate etc.; Absorption carrier is such as Kaolin and soap clay etc.; And lubricant, such as Talcum, calcium stearate and magnesium stearate and solid polyethylene glycol etc.

Chemical compound also can be mixed with is convenient to oral fragrant medicated wine or solution, or is mixed with the solution that is suitable for parenteral (for example intramuscular, subcutaneous or intravenous route).In addition, chemical compound is very suitable for being formulated as sustained release formulation etc.So make preparation, make that they may be in a period of time, only or preferably discharge active component in the special part of intestinal.Can for example make coating, film and protectiveness substrate by polymeric material or wax.

According to the required formula I chemical compound of Breast Cancer Prevention of the present invention, time limit that it is effective and enough especially and dosage depend on the correlative factor of patient's physiology (physical) characteristic, route of administration and attending doctor's evaluation.The preferred administration time limit was at least 6 months, and more preferably at least 1 year, most preferably at least 2 years or long-term.In general, daily dose acceptance and effective is about 0.1-1000mg/ days, preferably approximately 30-200mg/ days, and more preferably about 50-150mg/ days.Most preferred dosage range is about 60-120mg/ days, special recommendation 60mg/ days.

Described dosage range does not mean that restriction the present invention.On the contrary, the present invention of this range specification the present invention includes those identical scopes of function, and this compound chemistry prevention characteristic of discovery promptly is provided.Therefore, although some pattern of administration can allow formula I compound agent weight range different really, using according to the present invention effectively, the different really dosage range of this class is included in the present invention when identical with described scope function.

In addition, described dosage range is based on the hydrochlorate of formula I chemical compound, and therefore, the dosage of 60mg equals the 55.71mg free alkali.Those of ordinary skills can any pharmaceutically-acceptable salts of calculating formula I chemical compound the free alkali equivalent.For example, " approximately 60mg " comprises and the 55-65mg RALOXIFENE HCL comprises the 51.73-60.35mg free alkali simultaneously.

The specific embodiment

Oral administration of compound also is favourable.For this reason, can obtain following oral dosage form.

Prescription

Prescription 1: gelatine capsule

Prepare hard gelatin capsule with following component:

Component	Amount (mg/ capsule)
		RALOXIFENE HCL starch, but NF flow starch powder silicone fluid 350CSTK	30-200 0-650 0-650 0-15

Mix these components, by No. 45 U.S.'s screen clothes, in the hard gelatin capsule of packing into then.

Those prescriptions shown in below the example of capsule formula comprises:

Prescription 2: raloxifene capsule

Component	Amount (mg/ capsule)
		RALOXIFENE HCL starch, but NF flow starch powder silicone fluid 350 centistokes	30-200 112 225.3 1.7

Prescription 3: raloxifene capsule

Component	Amount (mg/ capsule)
		RALOXIFENE HCL starch, but NF flow starch powder silicone fluid 350 centistokes	30-200 108 225.3 1.7

Prescription 4: raloxifene capsule

Component	Amount (mg/ capsule)
		RALOXIFENE HCL starch, but NF flow starch powder silicone fluid 350 centistokes	30-200 103 225.3 1.7

Prescription 5: raloxifene capsule

Component	Amount (mg/ capsule)
		RALOXIFENE HCL starch, but NF flow starch powder silicone fluid 350 centistokes	30-200 150 397 3.0

More than concrete prescription can change according to the rational change range that provides.

Prepare tablet formulation with following component:

Prescription 6: tablet

Component	Amount (mg/ sheet)
		RALOXIFENE HCL microcrystalline Cellulose silicon dioxide is smoked stearic acid	30-200 0-650 0-650 0-15

Mix these components, be pressed into tablet then.

Perhaps, make following every tablet of tablet that contains the 0.1-1000mg active component:

Prescription 7: tablet

Component	Amount (mg/ sheet)
		RALOXIFENE HCL starch microcrystalline cellulose polyvinylpyrrolidone (10% solution in water) sodium carboxymethylcellulose magnesium stearate talc	30-200 45 35 4 4.5 0.5 1

Make described active component, starch and cellulose by 45 order U.S. sieves and fully mixing.Make polyvinylpyrrolidonesolution solution and the powder mixes that is produced, then by 14 order U.S. sieves.Make the granule that so makes in 50-60 ℃ of drying, and by 18 order U.S. sieves.Make carboxymethyl cellulose Starch Sodium, magnesium stearate and Pulvis Talci in advance by 60 order U.S. sieves, add then in the granule, mix the back and be pressed into tablet at tablet machine.

Make the suspension that contains the 0.1-1000mg medicine among following every 5ml:

Prescription 8: suspension

Component	Amount (mg/5ml)
		RALOXIFENE HCL sodium carboxymethylcellulose syrup benzoic acid solution flavoring pigment pure water adds to	An amount of 5ml of 30-200 50mg 1.25mg 0.10ml

Make this medicament by 45 order U.S. sieves, mix with sodium carboxymethyl cellulose and syrup then, form slick paste.Benzoic acid solution, flavoring and pigment with some water dilutions, are added while stir.Add enough water then, produce required volume.

Preferred tablet formulation comprises following two prescriptions:

Prescription 9:

Component	Amount (mg)	Function
			The crosslinked polyvidone of the spray-dired lactose Lactis Anhydrous of RALOXIFENE HCL PVP (Povidone) Tween 80 (crospovidone) dolomol (white (Color Mixture White) talcum Brazil wax of plate core weight's film coating colorant mixture	60.0 30.0 12.0 12.0 2.4 14.4 1.2 240.0) 12.0 trace--	Active component solubility diluent solubility diluent adhesive wetting agent disintegrant lubricant colouring agent polishing auxiliary agent polishing auxiliary agent

Prescription 10:

Component	Amount (mg)	Function
			The spray-dired lactose Lactis Anhydrous of RALOXIFENE HCL PVP Tween 80 PVPP dolomol (white (Color Mixture White) talcum Brazil wax of plate core weight's film coating colorant mixture	60.0 29.4 120.0 12.0 2.4 14.4 1.2 240.0) 12.0--trace	Active component solubility diluent solubility diluent adhesive wetting agent disintegrant lubricant colouring agent polishing auxiliary agent polishing auxiliary agent

Test procedure

Introduce the stage result of III phase raloxifene safety of clinical trials below, the support of effect practicality of the present invention.

Most of breast carcinoma cases come from 7704 postmenopausal women that confirm as osteoporosis in the osteoporosis therapy research of carrying out on a large scale.Yet, in the less scale study of the menopausal women that osteoporosis danger is arranged, reported other case.The research of this paper report be double blinding and compare with placebo; Great majority research has been carried out about 3 years, and its design is a purpose with prevention of mensuration raloxifene or the osteoporotic effect of treatment postmenopausal women.In addition, this research provides the data of cardiovascular health state and other main medical conditions (sickness rate that comprises breast carcinoma).Random assortment patient or accept placebo, perhaps every day oral 30mg, 60mg, 120mg or 150mg medicine.All patients and research worker all do not know to study the distribution (double blinding design) of medicine.Accept about 500mg/ days calcium additive 1 time all patients every day in each group.In addition, the patient in 7704 patients' extensive treatment research accepts 400-600IU/ days vitamin D additive.

These study selected experimenter is postmenopausal women's (apart from last menstrual cycle at least 2 years), olderly is about 45-80 year.

The general exclusion standard of participating in these researchs comprises: 1) have serious systemic disease, 2) acute or chronic hepatopathy, 3) renal function essence is impaired, 4) research worker is thought the experimenter of the medical treatment that comprises in its clinical trial or psychiatry risk factor poor (for example take drugs or excessive drinking etc.), 5) experimenter of cancer medical history is arranged in entering 5 years of research, surface damage exception, rodent ulcer for example, 6) there is a unusual metrorrhagia.Most important exclusion standard is to get rid of now or the past has breast carcinoma or other to rely on the women of estrogenic neoplasia personal history.These exclusion standards produce a population of subjects, reflected to have the general groups that develops into breast cancer risk, or in other words, those women do not develop into the extra high danger of breast carcinoma.

Before enrolling research, screen potential experimenter.The experimenter need reveal their medical history and present medical conditions.All potential patients need or clap the benchmark mammogram or carry out the breast ultrasound evaluation, have perhaps carried out wherein inspection in preceding 12 months entering research.In great majority research, need 2 years multiple mammogram; Yet, recommend annual mammogram.All experimenters that diagnose and be reported as breast carcinoma need termination at once to participate in research, and are inquired about by the research worker at scene, carry out suitable oncology and estimate and nurse.

For carrying out all placebo-controlled trials of 6 months at least and accepting more than all experimenters that studied Drug therapy in 1 month, 42 breast carcinoma cases have been reported altogether: compare with 18 cases in the raloxifene treatment group, in placebo group, observe 24 cases.Random assortment treatment patient's overall ratio (raloxifene and placebo) is approximately 2: 1.

The result is the experimenter who histopathology is diagnosed as breast carcinoma shown in the table 1-4.These data comprise the result from optional 1 year mammogram and required benchmark mammogram and 2 years multiple mammograms.In case be diagnosed as breast carcinoma, these experimenters just give up the study of, and with their situation decoding, distribute to their treatment (purpose) (being that what research medicine they accept) with announcement.

For the research of reporting among the present invention, patient's number that placebo is accepted in random assortment is approximately 3195.Patient's number of accepting raloxifene (merging all dosage) at random is approximately 6681.(in 7704 patients' extensive treatment research, the treatment password is not revealed to the patient who still enrolls research.Therefore, the patient's number that is assigned to each treatment group is an estimated value).

Below shown in the result be the patient who is diagnosed as breast carcinoma any time during studying [but after behind the random assortment research medicine (placebo or raloxifene) at least 1 month].Table 1 has been introduced the result of all placebo-controlled study and the data that merge all dosage of raloxifene.Table 2 has been introduced the case subgroup shown in the table 1, specifically enrolls the patient in 7704 patients' the extensive treatment research, and wherein most breast carcinoma case occurs in this subgroup.Two raloxifene dosage in this treatment research are 60mg/ days and 120mg/ days.Owing to the increase along with the age of the sickness rate of breast carcinoma increases, estimate that therefore this treatment research has higher breast cancer incidence [enter when studying, patient's mean age is 67 years old].These tables have been introduced 95% fiducial range that the breast carcinoma relative risk is estimated, developed into to the case load (n) of each treatment group breast carcinoma, the patient's sum (N) that distributes this treatment group, the relative risk that develops into breast carcinoma.We notice, if the upper limit of 95% fiducial range is lower than 1.0, statistical significance proves (being 5% level) so, are lower than the breast cancer incidence of usefulness placebo with the breast cancer incidence of raloxifene.

The relative risk analysis of table 1 breast carcinoma

All placebo-controlled study that merge

Be assigned to the time of diagnosis from treatment	The case n/N of placebo (%)	The case n/N of raloxifene (%)	Relative risk (raloxifene is to placebo)	95% fiducial range of relative risk
					At least 1 month at least 12 months	24/3195 21/3195	18/6681 10/6681	?0.36 ?0.23	(0.20，0.64) (0.11，0.45)

The relative risk analysis of table 2 breast carcinoma

Confirm extensive (7704 patients) treatment research of osteoporotic postmenopausal women

Be assigned to the time of diagnosis from treatment	The case n/N of placebo (%)	The case n/N of raloxifene (%)	Relative risk (raloxifene is to placebo)	95% fiducial range of relative risk
					At least 1 month at least 12 months	21/2659 18/2659	12/5317 5/5317	?0.29 ?0.14	(0.15，055) (0.06?0.32)

In these placebo-controlled study, these data clearly illustrate that the patient with placebo compares with random assortment, and random assortment reduces with the patient's of raloxifene breast cancer incidence.In 95% fiducial range (0.20,0.64), the rough estimate of patient's relative risk of all diagnosis of at least 1 month is 0.36 after random assortment is with the research medicine, and the ratio that demonstrates breast carcinoma reduces by 64%.When considering that separately extensive treatment is studied, in 95% fiducial range (0.15,0.55), the rough estimate of relative risk is 0.29, and the ratio that demonstrates breast carcinoma reduces by 71%.These results are highly statistical significances.

Because the cancer of time diagnosis at least 1 year behind the randomization, most probable is represented non-existent in advance clinically cancer, so we have also analyzed the data of only considering at random with the case that takes place at least 12 months the time behind the research medicine.All placebo-controlled study that are combined, in 95% fiducial range (0.11,0.45), the rough estimate of relative risk is 0.23, the sickness rate that is equivalent to breast carcinoma reduces by 77%.In 95% fiducial range (0.06,0.32), the rough estimate of extensive treatment research relative risk is 0.14, is equivalent to breast cancer incidence and reduces by 86%.

Appearance for tumor relevant in further analyzing and researching with time length, table 3 and table 4 have been introduced the relative risk data, it is divided into three periods: the 1) case that has the benchmark mammogram to repeat to diagnose, i.e. all cases of diagnosis in 1-6 month after the research medicament distribution; 2) case that repeats to diagnose by 1 year mammogram, i.e. all cases of diagnosis in 6-18 month after the research medicament distribution; 3) case that has 2 years mammograms to repeat to diagnose, i.e. all cases of diagnosis in 18-30 month after the research medicament distribution.

Table 3 has been introduced the relative risk of breast carcinoma in all placebo-controlled study that merge each period.Table 4 has been introduced a subgroup patient's of table 3 report data, i.e. patient in 7704 patients' extensive treatment research.Clearly, the relative risk that develops into breast carcinoma in two tables reduced along with each continuous multiple period.The relative risk of two colonies all reaches statistical significance when putting 2 year repetition time.

The relative risk that table 3 breast carcinoma is annual

All placebo-controlled study that merge ^a

Mammogram b	The case of placebo	The case of raloxifene	Relative risk	95% fiducial range of relative risk
					Benchmark (1-6 month) repeated (6-18 month) in 1 year and repeated (18-30 month) in 2 years	2 ? 6 ? 16 ?	5 ? 7 ? 5 ?	1.20 ? 0.56 ? 0.15	(0.23，6.15) ? (0.19，1.63) ? (0.06，0.36)

A randomization-raloxifene: placebo is 2: 1

Patient of b was diagnosed as breast carcinoma after 30 months, it is got rid of from this time category analysis.

The relative risk that table 4 breast carcinoma is annual

Be defined as extensive (7704 patients) treatment research of the menopausal women of osteoporosis ^a

Mammogram	The case of placebo	The case of raloxifene	Relative risk	95% fiducial range of relative risk
					Benchmark (1-6 month) repeated (6-18 month) in 1 year and repeated (18-30 month) in 2 years	2 6 13	5 4 3	1.25 0.33 0.12	(0.24，6.24) (0.10，1.11) (0.04，0.33)

A randomization-raloxifene: placebo is 2: 1

As last summary, Fig. 1 has shown the breast cancer incidence in all placebo-controlled study.(patient was diagnosed as breast carcinoma after 30 months, it is got rid of from this figure, therefore the figure shows about identical repetition period in two treatment groups.) two curves (placebo and raloxifene) almost can not distinguish before 1 year point, when they separated, the ratio that the generation breast carcinoma of placebo group increases was higher than the ratio that increases with the being seen generation breast carcinoma of raloxifene.

Claims (19)

1. the hydrochlorate of formula I chemical compound is used to prepare the purposes of the medicine that prevents postmenopausal women breast carcinoma, time limit that the administration of described medicine oral administration is enough and effective dose, and wherein said dosage is 55-65mg/ days

2. the purposes of claim 1, wherein said dosage is 60mg/ days.

3. claim 1 or 2 purposes, wherein said medicine contains the described salt of 60mg.

4. each purposes among the claim 1-3, the wherein said time limit was at least 6 months.

5. each purposes among the claim 1-3, the wherein said time limit was at least 1 year.

6. each purposes among the claim 1-3, the wherein said time limit was at least 2 years.

7. each purposes among the claim 1-3, the wherein said time limit is secular.

8. each purposes among the claim 1-7, wherein said postmenopausal women does not develop the special danger of breast carcinoma.

9. each purposes among the claim 1-7, wherein said postmenopausal women have the danger of the increase of development breast carcinoma.

10. each purposes among the claim 1-9, wherein said prevention are the initial stage preventions.

11. the pharmaceutical composition of Breast Cancer Prevention comprises the hydrochlorate of the formula I chemical compound of 60-120mg unit dose

With optional pharmaceutically acceptable excipient, diluent or carrier.

12. the pharmaceutical composition of claim 11 comprises the hydrochlorate of the formula I chemical compound of 55-65mg unit dose.

13. the pharmaceutical composition of claim 11 comprises the hydrochlorate of the formula I chemical compound of 60mg unit dose.

14. each pharmaceutical composition of claim 11-13, it is the form of oral administration.

15. each pharmaceutical composition of claim 11-13, it is the form of elixir or solution.

16. each pharmaceutical composition of claim 11-13, it is the sustained-release dosage form.

17. each pharmaceutical composition of claim 11-13, it is a tablet.

18. each pharmaceutical composition of claim 11-13, it is the gelatine capsule form.

19. each pharmaceutical composition of claim 11-13, it is a form of suspension.