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Aromatase inhibitors: rationale and use in breast cancer

Cynthia Osborne1, Debu Tripathy

  • 1University of Texas Southwestern Medical Center, Dallas, Texas 75390-8852, USA. cynthia.Osborne@utsouthwestern.edu

Annual Review of Medicine
|January 22, 2005
PubMed

Insights

Aromatase inhibitors (AIs) effectively reduce estrogen levels, showing greater clinical benefit than tamoxifen for breast cancer therapy and prevention. Long-term AI use may increase osteoporosis and fracture risks.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Estrogens play a key role in breast cancer development and progression.
  • Postmenopausal estrogen production primarily occurs via aromatase conversion of androgens.
  • Aromatase inhibitors (AIs) target this pathway to reduce estrogen levels.

Purpose of the Study:

  • To evaluate the efficacy and safety of aromatase inhibitors (AIs) in breast cancer treatment and prevention.
  • To compare the clinical benefit of AIs against tamoxifen.

Main Methods:

  • Large phase 3 randomized clinical trials were conducted.
  • Systemic and intratumoral estrogen levels were assessed.
  • Clinical outcomes including treatment efficacy and adverse events were analyzed.

Main Results:

  • Aromatase inhibitors demonstrated significant reductions in both systemic and intratumoral estrogens.
  • AIs provided greater clinical benefit compared to tamoxifen, the previous standard of care.
  • Long-term use of AIs is associated with an increased incidence of osteoporosis and bone fractures.

Conclusions:

  • Aromatase inhibitors are valuable therapeutic agents for breast cancer management.
  • AIs offer improved clinical benefit over tamoxifen for breast cancer therapy and potential prevention.
  • Careful monitoring for bone health is essential due to potential long-term side effects of AIs.

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