Melphalan Intravenous and Toremifene Citrate

• Generic Name: melphalan
• Dosage Forms: n.a.
• Other Brand Names: Alkeran, Alkeran IV, Evomela

Melphalan injection is used to treat multiple myeloma (bone marrow cancer) and as a conditioning treatment before a bone marrow transplantation procedure in patients with multiple myeloma. Melphalan belongs to the group of medicines called alkylating agents (cancer medicines). It works by interfering with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal cells may also be affected by melphalan, other unwanted effects will also occur. Before you begin treatment with melphalan, talk to your doctor about the benefits as well as the risks of using it.

Melphalan is to be given only by or under the direct supervision of your doctor.

• Generic Name: toremifene
• Dosage Forms: n.a.
• Other Brand Names: Fareston

Palliative treatment of metastatic breast cancer in postmenopausal women with estrogen-receptor positive or estrogen-receptor unknown tumors (designated an orphan drug by FDA for this use). Not recommended for treatment of estrogen-receptor negative breast tumors. Similar efficacy and toxicity as tamoxifen. Not known whether toremifene offers a therapeutic advantage over tamoxifen for the treatment of advanced breast cancer in eligible patients.

Under investigation for use as adjuvant therapy for early-stage breast cancer in node-positive postmenopausal women. Results from trials to date suggest similar efficacy and toxicity as tamoxifen.

Efficacy in treatment of advanced breast cancer in men not demonstrated.

Because of demonstrated cross-resistance with tamoxifen, usefulness of toremifene as second-line endocrine therapy for treatment of metastatic breast cancer refractory to tamoxifen appears to be limited.

Under investigation as a preventive agent for prostate cancer in men with high-grade prostatic intraepithelial neoplasia and no evidence of prostate cancer.