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[Aromatase inhibitors--new horizons in breast cancer endocrine therapy]
1Institut za onkologiju, Klinicki centar Univerziteta u Sarajevu, Bosna i Hercegovina.
Abstract:
The knowledge that breast cancers in a great percent of patients have specific estrogen (ER) and progesterone (PgR) receptors, which made them hormonal dependent, induced the development of a large choice of hormonal drugs for the treatment. The mortality rate of hormonal responsible breast cancer has been drastically decreased by different sequential hormonal manipulations. It is mostly due to tamoxifen, which is an ER blocator. As the synthesis of estrogens in postmenopausal women occurs through the aromatization of androgens, the third generation of new nonsteroidal aromatase inhibitors (AI), have been showed as strong drugs for endocrine therapy. Since they showed the advantage over tamoxifen in advanced breast cancer of postmenopausal women, there are currently the investigations of their value in early breast cancer adjuvant therapy, as well as the side-effects of the therapy. So far, tamoxifen remains a gold standard of adjuvant hormonal therapy for endocrine-dependent breast cancer.
Insights
Hormonal therapies like tamoxifen and aromatase inhibitors have significantly reduced breast cancer mortality. While aromatase inhibitors show promise in early-stage treatment, tamoxifen remains the standard for endocrine-dependent breast cancer.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Context:
- Estrogen (ER) and progesterone (PgR) receptors are present in a significant percentage of breast cancers, rendering them hormone-dependent.
- Hormonal therapies have drastically decreased mortality rates for hormone-responsive breast cancer.
- Tamoxifen, an ER blocker, has been a cornerstone in treatment, alongside newer aromatase inhibitors (AIs).
Purpose:
- To review the role of hormonal therapies in treating hormone-dependent breast cancer.
- To compare the efficacy and side effects of tamoxifen and third-generation nonsteroidal aromatase inhibitors.
- To discuss the current investigations into AI use in early breast cancer adjuvant therapy.
Summary:
- Hormone-dependent breast cancers are treated with drugs targeting estrogen receptors or synthesis.
- Third-generation aromatase inhibitors are effective in advanced breast cancer for postmenopausal women, showing advantages over tamoxifen.
- Research is ongoing to evaluate aromatase inhibitors for early breast cancer adjuvant therapy and their associated side effects.
Impact:
- Hormonal therapies have significantly improved survival rates for patients with hormone-dependent breast cancer.
- The development of aromatase inhibitors offers new treatment options, particularly for postmenopausal women.
- Ongoing research aims to optimize adjuvant endocrine therapy for early breast cancer, balancing efficacy and patient safety.
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