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55% пациентов с эпилепсией никогда не обращаются к специалисту. Как правильно диагностировать эпилептические приступы?
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Советы молодым</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="air-pollution-and-heart-disease-how-to-lower-your-risks-9" data-product-id="7374935031964" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374935031964 small--hide" title=" Quick shop " data-handle="air-pollution-and-heart-disease-how-to-lower-your-risks-9"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/air-pollution-and-heart-disease-how-to-lower-your-risks-9" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="150px" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Загрязнение воздуха и сердечно-сосудистые заболевания. Как снизить риски? Часть 9. 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title=" Quick shop " data-handle="alpha-ketoglutarate-and-longevity-how-to-use-it-with-vitamins-to-slow-aging-9"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/alpha-ketoglutarate-and-longevity-how-to-use-it-with-vitamins-to-slow-aging-9" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; 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> <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a> </li><li class="slide-nav__item"> <a href="/collections/womens-health" class="slide-nav__link"> <span>Women's Health. 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Как подобрать ингибиторы ароматазы?</h1></div> <div class="product-block" > <a class="custom-white-button" href="/pages/how-it-works" target="_self" rel="noopener noreferrer"> Can we help? </a> <style> .custom-white-button { background-color: transparent !important; color: #ffffff !important; border: 2px solid #ffffff !important; font-size: 18px !important; padding: 10px 20px !important; text-align: center !important; display: inline-block !important; text-decoration: none !important; } .custom-white-button:hover { background-color: #ff0000 !important; color: #ffffff !important; } </style> </div> </div> </div> <div class="grid__item one-whole"> <div class="product-summary--wide"> <div class="dd-article-summary rte"> <p>Leading expert in breast cancer treatment, Dr. Marc Lippman, MD, explains how to choose aromatase inhibitors. He details the lack of clinical difference between steroidal and non-steroidal types. Dr. Marc Lippman, MD, discusses the limitations of current Selective Estrogen Receptor Degraders (SERDs) like fulvestrant. He highlights the promise of new oral SERDs currently in advanced clinical trials. The conversation also covers the significant challenges of conducting large-scale adjuvant and prevention studies in breast cancer.</p> </div> </div> </div></div> </div> </section> <script type="application/ld+json"> {"@context":"http:\/\/schema.org\/","@id":"\/products\/breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8#product","@type":"Product","brand":{"@type":"Brand","name":"DiagnosticDetectives.Com"},"category":"","description":"Choosing Aromatase Inhibitors and Next-Generation SERDs for Breast Cancer\n\nJump To Section\n\nAromatase Inhibitor Types and Selection\nClinical Efficacy Comparison\nFulvestrant Challenges and Limitations\nOral SERDs Development and Promise\nClinical Trial Landscape and Future Directions\nAdjuvant Therapy Challenges\nFull Transcript\n\n\nAromatase Inhibitor Types and Selection\nDr. Marc Lippman, MD, explains that aromatase inhibitors come in two main types for breast cancer treatment. Type one includes steroidal, irreversible inhibitors like exemestane. Type two comprises non-steroidal, reversible inhibitors including anastrozole and letrozole. These medications work by blocking estrogen production in postmenopausal women with hormone receptor-positive breast cancer.\n\nClinical Efficacy Comparison\nAccording to Dr. Marc Lippman, MD, randomized clinical trials show no significant difference between aromatase inhibitor types. He emphasizes that these drugs are essentially cross-resistant and equally efficacious in breast cancer treatment. Dr. Marc Lippman, MD, notes that while some patients might report different side effects with different inhibitors, the clinical outcomes remain comparable. The choice between medications often comes down to individual patient tolerance rather than efficacy differences.\n\nFulvestrant Challenges and Limitations\nDr. Marc Lippman, MD, discusses the current Selective Estrogen Receptor Degrader (SERD) available for metastatic breast cancer. Fulvestrant requires monthly intramuscular injections, which can be uncomfortable for patients. The pharmacology presents significant challenges in achieving effective drug concentrations. Dr. Marc Lippman, MD, explains that fulvestrant operates at the very edge of effective concentrations, making optimal dosing difficult.\n\nOral SERDs Development and Promise\nThe development of oral Selective Estrogen Receptor Degraders represents a major advancement in breast cancer treatment. Dr. Marc Lippman, MD, expresses excitement about these new agents, noting they appear more potent than fulvestrant. Early data suggests oral SERDs may work in patients who have progressed on fulvestrant therapy. These new medications are currently in advanced clinical trials and may receive FDA approval soon.\n\nClinical Trial Landscape and Future Directions\nDr. Marc Lippman, MD, describes ongoing clinical trials combining oral SERDs with CDK4\/6 inhibitors for breast cancer treatment. This combination approach could represent a significant step forward in metastatic breast cancer management. The natural progression of cancer therapies typically moves from metastatic to adjuvant settings. Researchers are also considering SERDs for potential breast cancer prevention trials, though these present substantial challenges.\n\nAdjuvant Therapy Challenges\nDr. Marc Lippman, MD, highlights the difficulties in conducting adjuvant therapy studies for early-stage breast cancer. Patients with T1N0 breast cancer discovered by mammography have excellent outcomes with standard endocrine therapy. Only about 10% of these patients experience recurrence within five years. Improving these results requires treating tens of thousands of women with long follow-up periods, making such studies extremely expensive and time-consuming. Dr. Anton Titov, MD, facilitates this discussion about the practical challenges in breast cancer research advancement.\nFull Transcript\nDr. Marc Lippman, MD: Aromatase inhibitors can be of two types. Exemestane is type one, or steroidal, irreversible aromatase inhibitor. Anastrozole and letrozole are examples of type two, non-steroidal, reversible aromatase inhibitors.\n\nDr. Anton Titov, MD: How to choose correct aromatase inhibitors for specific breast cancer patient?\n\nDr. Marc Lippman, MD: It makes no difference whatsoever. For the aromatase inhibitors, it makes no difference. This is a case of drug companies marketing, trying to lobby one against the other just because they have two drugs. Randomized trials of one aromatase inhibitor versus another suggest no difference.\n\nIn my view, aromatase inhibitors are almost completely cross-resistant. Rarely a patient says, \"Gee, this drug makes me feel terrible. I'll try a different one.\" Sometimes, either it's lucky or psychological, or there's some minor difference in the pharmacology. Then switching from one aromatase inhibitor to another one works. Still, they are almost equally efficacious.\n\nSo there's only one SERD around now: Selective Estrogen Receptor Degrader. That's fulvestrant. It is challenging to use because you have to take it by injection in your behind once a month, and it's a little bit uncomfortable.\n\nBut the main problem with fulvestrant is that its pharmacology is such that you really are at the very edge of effective concentrations. It's very hard to get enough drug into people.\n\nThere are newest trials of oral Selective Estrogen Receptor Degraders. Oral SERDs are more potent. It turns out that many SERDs seem to work in patients who have progressed on fulvestrant or had fulvestrant failures. Everybody's excited about SERDs. I'm very excited about Selective Estrogen Receptor Degraders.\n\nIt remains to be seen how they will replace fulvestrant. Maybe they'll become first-line drugs. The trials being discussed are underway with CDK4\/6 inhibitors. So this may be a very important step forward in more effective treatment for women with breast cancer.\n\nI'd rather not use brand names of oral SERDs because they are still in development. But the most recent oral SERDs have already been in randomized clinical trials. I suspect they are about to be in front of the FDA. I think approvals this spring or summer are likely for at least one of oral Selective Estrogen Receptor Degraders.\n\nSelective Estrogen Receptor Degraders are often used in metastatic breast cancer. As I've said several times in our discussion today, the natural history of cancer therapies is to immediately try to advance them to the adjuvant chemotherapy setting. And I suppose even consider SERDs in breast cancer prevention trials.\n\nBut no one wants to do prevention clinical trials. It's too expensive. They are too costly. There is too much of a downside. Drug companies are desperately afraid of prevention clinical trials. And that's unfortunate, but it's the truth.\n\nThe problem with adjuvant chemotherapy in breast cancer studies is good news. The good news is this: if you take patients with early-stage breast cancer, even though I've told you that they can continue to relapse for decades, the fact is this. You take women who are discovered by mammography to have T1N0 breast cancer. You put them on standard endocrine therapy. You're not going to see 10% of them recur in five years.\n\nSo if you're going to try to improve on that result, think of the tens of thousands of women you have to treat. Think how long you have to follow these women with breast cancer. So the data here will be very slow coming and very expensive to obtain.","image":"https:\/\/diagnosticdetectives.ru\/cdn\/shop\/products\/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917\u0026width=1920","name":"Гормональная терапия при раке молочной железы. Как подобрать ингибиторы ароматазы?","offers":{"@id":"\/products\/breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8?variant=42435495264412#offer","@type":"Offer","availability":"http:\/\/schema.org\/InStock","price":"0.00","priceCurrency":"RUB","url":"https:\/\/diagnosticdetectives.ru\/products\/breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8?variant=42435495264412"},"url":"https:\/\/diagnosticdetectives.ru\/products\/breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8"} </script> </div><section id="shopify-section-template--18622507942044__product_expert_masterclass_teaser_GQjD4Q" class="shopify-section index-section"> </section><div id="shopify-section-template--18622507942044__more-products-collection" class="shopify-section"> <div data-subsection data-section-id="template--18622507942044__more-products-collection" data-section-type="collection-template" > <div class="index-section index-section--sub-product"> <div class="page-width"> <header class="section-header"> <div class="h3 section-header__title"> More from <a href="/collections/how-to">How to...</a> </div> </header> </div> <div class="page-width page-width--flush-small"> <div class="new-grid product-grid scrollable-grid--small" data-view="medium" > <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="55-of-epilepsy-patients-never-see-an-expert-how-to-diagnose-epileptic-seizures-correctly-2" data-product-id="7374936834204" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374936834204 small--hide" title=" Quick shop " data-handle="55-of-epilepsy-patients-never-see-an-expert-how-to-diagnose-epileptic-seizures-correctly-2"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/55-of-epilepsy-patients-never-see-an-expert-how-to-diagnose-epileptic-seizures-correctly-2" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Tracey_Milligan_Medical_Second_Opinion_Diagnostic_Detectives_Network_Epilepsy-treatment-seizures-refractory-diet-cannabidiol.003.jpg?v=1660933378&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">55% пациентов с эпилепсией никогда не обращаются к специалисту. Как правильно диагностировать эпилептические приступы?</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="advice-to-young-neurosurgeons-how-to-become-a-skilled-surgeon-8" data-product-id="7374949220508" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374949220508 small--hide" title=" Quick shop " data-handle="advice-to-young-neurosurgeons-how-to-become-a-skilled-surgeon-8"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/advice-to-young-neurosurgeons-how-to-become-a-skilled-surgeon-8" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Acoustic-Neuroma-Treatment-Skull-Base-Neurosurgery-Second-Opinion-DiagnosticDetectiveCom.008.jpg?v=1660992694&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title"><!DOCTYPE html> <html lang="ru"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>Советы молодым</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="air-pollution-and-heart-disease-how-to-lower-your-risks-9" data-product-id="7374935031964" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374935031964 small--hide" title=" Quick shop " data-handle="air-pollution-and-heart-disease-how-to-lower-your-risks-9"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/air-pollution-and-heart-disease-how-to-lower-your-risks-9" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Pier-Mannuccio_Mannucci_thrombosis_bleeding_hematology_treatment_Diagnostic_Detectives_Network.010.jpg?v=1660905407&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Загрязнение воздуха и сердечно-сосудистые заболевания. Как снизить риски? Часть 9. [Части 1 и 2]</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> </div> </div> </div> </div> </div><div id="shopify-section-template--18622507942044__more-products-vendor" class="shopify-section"> <is-land on:visible> <vendor-products data-subsection data-section-id="template--18622507942044__more-products-vendor" data-section-type="vendor-products" data-product-id="7600709927068" data-vendor-url="/collections/vendors?q=DiagnosticDetectives.Com" data-max-products="3" > <div class="index-section index-section--sub-product"> <div class="page-width"> <header class="section-header"> <div class="h3 section-header__title"> More from <a href="/collections/vendors?q=DiagnosticDetectives.Com" title="DiagnosticDetectives.Com">DiagnosticDetectives.Com</a> </div> </header> </div> <div class="page-width page-width--flush-small"> <div id="VendorProducts-template--18622507942044__more-products-vendor" class="new-grid product-grid scrollable-grid--small" data-view="medium" > <div class="visually-invisible"> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8" data-product-id="7600709927068" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7600709927068 small--hide" title=" Quick shop " data-handle="breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/how-to/products/breast-cancer-hormone-therapy-how-to-choose-aromatase-inhibitors-8" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Marc_Lippman_Breast_Cancer_Treatment_Expert_Second_Opinion_Diagnostic_Detectives_Network.008.jpg?v=1680673917&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Гормональная терапия при раке молочной железы. Как подобрать ингибиторы ароматазы?</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> </div> </div> </div> </div> </vendor-products> <template data-island> <script type="module"> import 'components/section-more-products-vendor' </script> </template> </is-land> </div><div id="shopify-section-template--18622507942044__collection-return" class="shopify-section"> <div class="return-section color-scheme-none"><div class="page-width text-center"> <a href="/collections/how-to" class="btn return-link" > <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon--wide icon-arrow-left" viewbox="0 0 50 15" fill="currentColor" width="20" height="20" > <path d="M50 5.38v4.25H15V15L0 7.5 15 0v5.38Z" /> </svg> Back to How to... </a> </div> </div> </div><div id="shopify-section-template--18622507942044__featured_product_LHGeFD" class="shopify-section index-section"> <section class="page-content page-content--product page-content--partial" data-section-id="template--18622507942044__featured_product_LHGeFD" data-product-id="7374955085980" > <div class="page-width"> <div class="product-grid__container product--images float-grid grid--product-images--partial clearfix"><div class="grid__item medium-up--one-half product-single__sticky"> <product-images data-product-images data-zoom="false" data-has-slideshow="false" data-media-gallery-layout="" data-modal="false" data-product-id="7374955085980" data-section-id="template--18622507942044__featured_product_LHGeFD" > <div class="product__photos product__photos-template--18622507942044__featured_product_LHGeFD product__photos--beside"> <div class="product__main-photos" data-product-single-media-group> <div data-product-photos data-zoom="false" class="product-slideshow" id="ProductPhotos-template--18622507942044__featured_product_LHGeFD" > <div class="product-main-slide starting-slide" data-index="0" data-media-id="26893580828828" > <div data-product-image-main class="product-image-main" ><div class="image-wrap hide" style="height: 0; padding-bottom: 41.666666666666664%;" > <is-land on:visible data-image-type="photoswipe"> <img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1080" alt="Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю." srcset="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1080 1080w" width="1080" height="450.0" loading="eager" class=" image-element" data-photoswipe-src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1800" data-photoswipe-width="1920" data-photoswipe-height="800" data-index="1" sizes=" (min-width: 769px) 50vw, 75vw" data-animate="none"> </is-land> </div><div class="product__video-wrapper"> <is-land on:idle> <div class="video-media aspect-ratio--16-9" data-background="false" ><video-media defer-hydration > <video playsinline="true" controls="controls" preload="metadata" aria-label="Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю." poster="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002_500x.jpg?v=1666367638"><source src="//diagnosticdetectives.ru/cdn/shop/videos/c/vp/a22b0d50e4c64d9c8b0a558888197f4a/a22b0d50e4c64d9c8b0a558888197f4a.HD-720p-4.5Mbps-8813343.mp4?v=0" type="video/mp4"><img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002_500x.jpg?v=1666367638"></video> </video-media></div> <template data-island> <script type="module"> import 'components/video-media' </script> </template> </is-land> </div></div> </div> </div></div> <div data-product-thumbs class="product__thumbs product__thumbs--beside product__thumbs-placement--left medium-up--hide small--hide" data-position="beside" data-arrows="false" ><div class="product__thumbs--scroller"></div></div> </div> <script type="application/json" data-current-variant-json>{"id":41852130001052,"title":"Default Title","option1":"Default Title","option2":null,"option3":null,"sku":"","requires_shipping":false,"taxable":false,"featured_image":null,"available":true,"name":"Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю.","public_title":null,"options":["Default Title"],"price":0,"weight":0,"compare_at_price":null,"inventory_management":null,"barcode":"","requires_selling_plan":false,"selling_plan_allocations":[]}</script> <script type="application/json" data-product-options-json>["Title"]</script> </product-images> <script type="module"> import 'components/product-images' </script> <script type="application/json" id="ModelJson-template--18622507942044__featured_product_LHGeFD"> [] </script><div class="localized-video-iframe-container" style="margin-top: 1.5rem;"> <div id="language-selector-wrapper"> <label for="language-selector">🎧 Select dubbed video language:</label> <select id="language-selector"> <option value="">Choose dubbed language</option> <option value="de" >Deutsch</option> <option value="fr" >Français</option> <option value="ru" selected>Русский</option> <option value="it" >Italiano</option> <option value="es" >Español</option> <option value="pt" >Português</option> <option value="ar" >العربية</option> <option value="zh" >中文</option> <option value="ja" >日本語</option> <option value="ko" >한국어</option> </select> </div> <iframe id="localized-video-iframe" src="https://player.vimeo.com/video/1113043591?autoplay=0&title=0&byline=0&portrait=0" data-selected-lang="ru" frameborder="0" allow="autoplay; 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color: #ffffff !important; border: 2px solid #ffffff !important; font-size: 18px !important; padding: 10px 20px !important; text-align: center !important; display: inline-block !important; text-decoration: none !important; } .custom-white-button:hover { background-color: #ff0000 !important; color: #ffffff !important; } </style> </div> </div> </div><div class="grid__item medium-up--one-half product-single__sticky"> <product-images data-product-images data-zoom="false" data-has-slideshow="false" data-media-gallery-layout="" data-modal="false" data-product-id="7374955151516" data-section-id="template--18622507942044__featured_product_ik9hhY" > <div class="product__photos product__photos-template--18622507942044__featured_product_ik9hhY product__photos--beside"> <div class="product__main-photos" data-product-single-media-group> <div data-product-photos data-zoom="false" class="product-slideshow" id="ProductPhotos-template--18622507942044__featured_product_ik9hhY" > <div class="product-main-slide starting-slide" data-index="0" data-media-id="26893628440732" > <div data-product-image-main class="product-image-main" ><div class="image-wrap hide" style="height: 0; padding-bottom: 41.666666666666664%;" > <is-land on:visible data-image-type="photoswipe"> <img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=1080" alt="Подбор идеальных хирургов или медицинских специалистов для проведения вашего лечения." srcset="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=1080 1080w" width="1080" height="450.0" loading="eager" class=" image-element" data-photoswipe-src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1.jpg?v=1660755068&width=1800" data-photoswipe-width="1920" data-photoswipe-height="800" data-index="1" sizes=" (min-width: 769px) 50vw, 75vw" data-animate="none"> </is-land> </div><div class="product__video-wrapper"> <is-land on:idle> <div class="video-media aspect-ratio--16-9" data-background="false" ><video-media defer-hydration > <video playsinline="true" controls="controls" preload="metadata" aria-label="Подбор идеальных хирургов или медицинских специалистов для проведения вашего лечения." poster="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1_500x.jpg?v=1660755068"><source src="//diagnosticdetectives.ru/cdn/shop/videos/c/vp/2784406d62054c4da459927e30451d40/2784406d62054c4da459927e30451d40.HD-720p-4.5Mbps-8813682.mp4?v=0" type="video/mp4"><img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhD_2.002_3c4586c3-94b5-47b0-a751-2a382ef567a1_500x.jpg?v=1660755068"></video> </video-media></div> <template data-island> <script type="module"> import 'components/video-media' </script> </template> </is-land> </div></div> </div> </div></div> <div data-product-thumbs class="product__thumbs product__thumbs--beside product__thumbs-placement--right medium-up--hide small--hide" data-position="beside" data-arrows="false" ><div class="product__thumbs--scroller"></div></div> </div> <script type="application/json" data-current-variant-json>{"id":41852130066588,"title":"Default Title","option1":"Default Title","option2":null,"option3":null,"sku":"","requires_shipping":false,"taxable":false,"featured_image":null,"available":true,"name":"Подбор идеальных хирургов или медицинских специалистов для проведения вашего лечения.","public_title":null,"options":["Default Title"],"price":0,"weight":0,"compare_at_price":null,"inventory_management":null,"barcode":"","requires_selling_plan":false,"selling_plan_allocations":[]}</script> <script type="application/json" data-product-options-json>["Title"]</script> </product-images> <script type="module"> import 'components/product-images' </script> <script type="application/json" id="ModelJson-template--18622507942044__featured_product_ik9hhY"> [] </script></div></div> </div> </section> <script> document.addEventListener("DOMContentLoaded", function () { const selector = document.getElementById("language-selector"); const iframe = document.getElementById("localized-video-iframe"); if (!selector || !iframe) return; // 🧠 Detect the language used in video (via data attribute from Liquid) const loadedLang = iframe.getAttribute("data-selected-lang"); if (loadedLang) { selector.value = loadedLang; } // 🧠 On dropdown change, switch video selector.addEventListener("change", function () { const lang = selector.value; if (!lang) return; const metafieldUrl = {}; const urlKey = "vimeo_url_" + lang; const newUrl = metafieldUrl[urlKey]; if (newUrl) { iframe.src = newUrl + "?autoplay=0&title=0&byline=0&portrait=0"; } }); }); </script> </div><div id="shopify-section-template--18622507942044__sub" class="shopify-section product-full-width"> <div class="page-width page-width--narrow"> <div class="product-block" > <at-rte class="at-rte rte clearfix"> <h1>Choosing Aromatase Inhibitors and Next-Generation SERDs for Breast Cancer</h1> <h3>Jump To Section</h3> <ul> <li><a href="#aromatase-inhibitor-types">Aromatase Inhibitor Types and Selection</a></li> <li><a href="#clinical-efficacy-comparison">Clinical Efficacy Comparison</a></li> <li><a href="#fulvestrant-challenges">Fulvestrant Challenges and Limitations</a></li> <li><a href="#oral-serds-development">Oral SERDs Development and Promise</a></li> <li><a href="#clinical-trial-landscape">Clinical Trial Landscape and Future Directions</a></li> <li><a href="#adjuvant-therapy-challenges">Adjuvant Therapy Challenges</a></li> <li><a href="#full-transcript">Full Transcript</a></li> </ul> <h2 id="aromatase-inhibitor-types">Aromatase Inhibitor Types and Selection</h2> <p>Dr. Marc Lippman, MD, explains that aromatase inhibitors come in two main types for breast cancer treatment. Type one includes steroidal, irreversible inhibitors like exemestane. Type two comprises non-steroidal, reversible inhibitors including anastrozole and letrozole. These medications work by blocking estrogen production in postmenopausal women with hormone receptor-positive breast cancer.</p> <h2 id="clinical-efficacy-comparison">Clinical Efficacy Comparison</h2> <p>According to Dr. Marc Lippman, MD, randomized clinical trials show no significant difference between aromatase inhibitor types. He emphasizes that these drugs are essentially cross-resistant and equally efficacious in breast cancer treatment. Dr. Marc Lippman, MD, notes that while some patients might report different side effects with different inhibitors, the clinical outcomes remain comparable. The choice between medications often comes down to individual patient tolerance rather than efficacy differences.</p> <h2 id="fulvestrant-challenges">Fulvestrant Challenges and Limitations</h2> <p>Dr. Marc Lippman, MD, discusses the current Selective Estrogen Receptor Degrader (SERD) available for metastatic breast cancer. Fulvestrant requires monthly intramuscular injections, which can be uncomfortable for patients. The pharmacology presents significant challenges in achieving effective drug concentrations. Dr. Marc Lippman, MD, explains that fulvestrant operates at the very edge of effective concentrations, making optimal dosing difficult.</p> <h2 id="oral-serds-development">Oral SERDs Development and Promise</h2> <p>The development of oral Selective Estrogen Receptor Degraders represents a major advancement in breast cancer treatment. Dr. Marc Lippman, MD, expresses excitement about these new agents, noting they appear more potent than fulvestrant. Early data suggests oral SERDs may work in patients who have progressed on fulvestrant therapy. These new medications are currently in advanced clinical trials and may receive FDA approval soon.</p> <h2 id="clinical-trial-landscape">Clinical Trial Landscape and Future Directions</h2> <p>Dr. Marc Lippman, MD, describes ongoing clinical trials combining oral SERDs with CDK4/6 inhibitors for breast cancer treatment. This combination approach could represent a significant step forward in metastatic breast cancer management. The natural progression of cancer therapies typically moves from metastatic to adjuvant settings. Researchers are also considering SERDs for potential breast cancer prevention trials, though these present substantial challenges.</p> <h2 id="adjuvant-therapy-challenges">Adjuvant Therapy Challenges</h2> <p>Dr. Marc Lippman, MD, highlights the difficulties in conducting adjuvant therapy studies for early-stage breast cancer. Patients with T1N0 breast cancer discovered by mammography have excellent outcomes with standard endocrine therapy. Only about 10% of these patients experience recurrence within five years. Improving these results requires treating tens of thousands of women with long follow-up periods, making such studies extremely expensive and time-consuming. Dr. Anton Titov, MD, facilitates this discussion about the practical challenges in breast cancer research advancement.</p> <h2 id="full-transcript">Full Transcript</h2> <p><strong>Dr. Marc Lippman, MD:</strong> Aromatase inhibitors can be of two types. Exemestane is type one, or steroidal, irreversible aromatase inhibitor. Anastrozole and letrozole are examples of type two, non-steroidal, reversible aromatase inhibitors.</p> <p><strong>Dr. Anton Titov, MD:</strong> How to choose correct aromatase inhibitors for specific breast cancer patient?</p> <p><strong>Dr. Marc Lippman, MD:</strong> It makes no difference whatsoever. For the aromatase inhibitors, it makes no difference. This is a case of drug companies marketing, trying to lobby one against the other just because they have two drugs. Randomized trials of one aromatase inhibitor versus another suggest no difference.</p> <p>In my view, aromatase inhibitors are almost completely cross-resistant. Rarely a patient says, "Gee, this drug makes me feel terrible. I'll try a different one." Sometimes, either it's lucky or psychological, or there's some minor difference in the pharmacology. Then switching from one aromatase inhibitor to another one works. Still, they are almost equally efficacious.</p> <p>So there's only one SERD around now: Selective Estrogen Receptor Degrader. That's fulvestrant. It is challenging to use because you have to take it by injection in your behind once a month, and it's a little bit uncomfortable.</p> <p>But the main problem with fulvestrant is that its pharmacology is such that you really are at the very edge of effective concentrations. It's very hard to get enough drug into people.</p> <p>There are newest trials of oral Selective Estrogen Receptor Degraders. Oral SERDs are more potent. It turns out that many SERDs seem to work in patients who have progressed on fulvestrant or had fulvestrant failures. Everybody's excited about SERDs. I'm very excited about Selective Estrogen Receptor Degraders.</p> <p>It remains to be seen how they will replace fulvestrant. Maybe they'll become first-line drugs. The trials being discussed are underway with CDK4/6 inhibitors. So this may be a very important step forward in more effective treatment for women with breast cancer.</p> <p>I'd rather not use brand names of oral SERDs because they are still in development. But the most recent oral SERDs have already been in randomized clinical trials. I suspect they are about to be in front of the FDA. I think approvals this spring or summer are likely for at least one of oral Selective Estrogen Receptor Degraders.</p> <p>Selective Estrogen Receptor Degraders are often used in metastatic breast cancer. As I've said several times in our discussion today, the natural history of cancer therapies is to immediately try to advance them to the adjuvant chemotherapy setting. And I suppose even consider SERDs in breast cancer prevention trials.</p> <p>But no one wants to do prevention clinical trials. It's too expensive. They are too costly. There is too much of a downside. Drug companies are desperately afraid of prevention clinical trials. And that's unfortunate, but it's the truth.</p> <p>The problem with adjuvant chemotherapy in breast cancer studies is good news. The good news is this: if you take patients with early-stage breast cancer, even though I've told you that they can continue to relapse for decades, the fact is this. You take women who are discovered by mammography to have T1N0 breast cancer. You put them on standard endocrine therapy. You're not going to see 10% of them recur in five years.</p> <p>So if you're going to try to improve on that result, think of the tens of thousands of women you have to treat. Think how long you have to follow these women with breast cancer. So the data here will be very slow coming and very expensive to obtain.</p> </at-rte> <script type="module"> import 'components/rte' </script> </div> </div> </div> </main><!-- BEGIN sections: footer-group --> <div id="shopify-section-sections--18523926593692__footer" class="shopify-section shopify-section-group-footer-group"> <div class="footer__section footer__section--border"> <div class="page-width"> <div class="footer__newsletter"><div class="footer__subscribe rte rte--nomargin clearfix"> <p><strong>Get high-impact health ideas [1x month]</strong></p> </div> <form method="post" action="/contact#newsletter-sections--18523926593692__footer" id="newsletter-sections--18523926593692__footer" accept-charset="UTF-8" class="contact-form"><input type="hidden" name="form_type" value="customer" /><input type="hidden" name="utf8" value="✓" /> <label for="Email-sections--18523926593692__footer" class="visually-hidden"> Enter your email </label> <label for="newsletter-form-submit-sections--18523926593692__footer" class="visually-hidden"> Subscribe </label> <input type="hidden" name="contact[tags]" value="prospect,newsletter"> <input type="hidden" name="contact[context]" value="footer"> <div class="input-group newsletter__input-group"> <input type="email" value="" placeholder=" Enter your email " name="contact[email]" id="Email-sections--18523926593692__footer" class="input-group-field newsletter__input" autocorrect="off" autocapitalize="off" required > <div class="input-group-btn"> <button type="submit" id="newsletter-form-submit-sections--18523926593692__footer" class="btn" name="commit" aria-label=" Subscribe " > <span class="form__submit--large"> Subscribe </span> <span class="form__submit--small"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon--wide icon-arrow-right" viewbox="0 0 50 15" fill="currentColor" width="20" height="20" > <path d="M0 9.63V5.38h35V0l15 7.5L35 15V9.63Z" /> </svg> </span> </button> </div> </div></form> </div> </div> </div> <div id="FooterMobileNavWrap" class="footer__section footer__section--border medium-up--hide"> <div id="FooterMobileNav" class="page-width"></div> </div><is-land on:visible> <footer-section class="site-footer" data-section-id="sections--18523926593692__footer" data-section-type="footer-section"> <div id="FooterMenus" class="footer__section footer__section--menus " > <div class="page-width"> <div class="footer__blocks"><div class="footer__block footer__block--menu" data-type="menu" > <h2 class="footer__title h4"> About us </h2> <ul class="footer__menu"><li> <a href="/pages/our-mission-story">About us. 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Story.</a> </li><li> <a href="/pages/expert-advisory-board">Expert Advisory Board</a> </li><li> <a href="/pages/expert-testimonials">Expert Testimonials</a> </li></ul> </div><div class="footer__block footer__block--payment" data-type="payment" > <div class="footer__mobile-section"> <div class="footer__blocks--mobile"></div> </div> </div></div> </div> </div> <div class="footer__section"> <div class="page-width text-center small--text-left"> <div class="footer__base-links"><span> © 2025 DiagnosticDetectives.Com </span><a target="_blank" rel="nofollow" href="https://www.shopify.com?utm_campaign=poweredby&utm_medium=shopify&utm_source=onlinestore">На платформе Shopify</a> </div> </div> </div> </footer-section> <template data-island> <script type="module"> import 'components/section-footer' </script> </template> </is-land> </div> <!-- END sections: footer-group --></div> </div> <div class="pswp" tabindex="-1" role="dialog" aria-hidden="true"> <div class="pswp__bg"></div> <div class="pswp__scroll-wrap"> <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div> <div class="pswp__ui pswp__ui--hidden"> <button class="btn btn--secondary btn--circle pswp__button pswp__button--arrow--left" title=" Previous " > <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-left" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M249.49 0a35 35 0 0 1 24.75 59.75L84.49 249.49l189.75 189.74a35.002 35.002 0 1 1-49.5 49.5L10.25 274.24a35 35 0 0 1 0-49.5L224.74 10.25A34.89 34.89 0 0 1 249.49 0" /> </svg> </button> <button class="btn btn--secondary btn--circle btn--large pswp__button pswp__button--close" title=" Close (esc) " > <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-close icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="m19 17.61 27.12 27.13m0-27.13L19 44.74" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> </button> <button class="btn btn--secondary btn--circle pswp__button pswp__button--arrow--right" title=" Next " > <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </button> </div> </div> </div> <tool-tip data-tool-tip=""> <div class="tool-tip__inner" data-tool-tip-inner> <button class="tool-tip__close btn btn--circle btn--icon" data-tool-tip-close=""> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-close icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="m19 17.61 27.12 27.13m0-27.13L19 44.74" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> </button> <div data-tool-tip-title>Гормональная терапия при раке молочной железы. Как подобрать ингибитор</div> <div class="tool-tip__content" data-tool-tip-content></div> </div> </tool-tip> <script type="module"> import 'components/tool-tip' </script> </body> </html>