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Aromatase inhibitors for chemoprevention

Paul E Goss1, Kathrin Strasser-Weippl

  • 1Medical Oncology, Princess Margaret Hospital, University Health Network, 610 University Avenue, 5-303, Toronto, Ontario, Canada M5G 2M9. pegoss@interlog.com

Best Practice & Research. Clinical Endocrinology & Metabolism
|December 23, 2003
PubMed

Insights

Estrogen plays a role in breast cancer development. Tamoxifen and aromatase inhibitors are used to block estrogen, with ongoing trials evaluating their effectiveness and safety for breast cancer risk reduction.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Estrogen is implicated in breast cancer initiation and promotion.
  • Estrogen antagonism is a strategy for breast cancer risk reduction.
  • Tamoxifen and aromatase inhibitors are key therapeutic agents.

Purpose of the Study:

  • To review the role of estrogen in breast cancer.
  • To compare the efficacy and toxicity of tamoxifen and aromatase inhibitors.
  • To highlight ongoing clinical trials investigating these agents.

Main Methods:

  • Review of pre-clinical, molecular, and epidemiological evidence.
  • Analysis of data from phase III clinical trials of tamoxifen and aromatase inhibitors.
  • Discussion of ongoing trials such as IBIS 2 and NCIC CTG MAP.3.

Main Results:

  • Tamoxifen has demonstrated substantial reduction in tumor occurrence.
  • Aromatase inhibitors show superiority over tamoxifen in advanced, neoadjuvant, and adjuvant settings.
  • Exemestane's steroidal structure may offer benefits for bone and lipid metabolism.

Conclusions:

  • Estrogen antagonism is a validated approach for breast cancer risk reduction.
  • Aromatase inhibitors represent an advancement over tamoxifen in breast cancer treatment.
  • Further results from ongoing trials are anticipated to refine risk profiles and treatment strategies.

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