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Enhancement of Apoptotic and Autophagic Induction by a Novel Synthetic C-1 Analogue of 7-deoxypancratistatin in Human Breast Adenocarcinoma and Neuroblastoma Cells with Tamoxifen
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Aromatase inhibitors for therapy of advanced breast cancer

James N Ingle1, Vera J Suman

  • 1Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. ingle.james@mayo.edu

The Journal of Steroid Biochemistry and Molecular Biology
|June 9, 2005
PubMed

Insights

Third-generation aromatase inhibitors (AIs) are effective for postmenopausal women with advanced breast cancer, showing comparable or superior efficacy to older treatments with fewer side effects. Further research is needed for premenopausal women.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Third-generation non-steroidal aromatase inhibitors (NS-AIs) like anastrozole and letrozole, and steroidal AI (S-AI) exemestane, have been extensively studied in postmenopausal women with advanced breast cancer.
  • These agents have been compared against tamoxifen in the first-line setting and megestrol acetate in the second-line setting.

Purpose of the Study:

  • To evaluate the efficacy and toxicity profiles of third-generation AIs compared to older endocrine therapies.
  • To assess the clinical implications of potency differences among NS-AIs and S-AI.
  • To review the current data and future directions for AI use in premenopausal women.

Main Methods:

  • Numerous phase III clinical trials were analyzed.
  • Efficacy endpoints and toxicity profiles, including thrombotic events, were compared.

Main Results:

  • Aromatase inhibitors demonstrated at least equivalent or superior efficacy in certain endpoints compared to tamoxifen and megestrol acetate.
  • AIs exhibited a preferable toxicity profile, notably a lower incidence of thrombotic events.
  • Minor potency differences among the three AIs have not been clinically substantiated.

Conclusions:

  • Aromatase inhibitors are a valuable treatment option for postmenopausal women with advanced breast cancer.
  • The established role of AIs in adjuvant therapy may influence their use in advanced disease.
  • Further investigation into the use of third-generation AIs, particularly in combination with ovarian function suppression, is warranted for premenopausal women, focusing on adjuvant settings.

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