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Future uses for aromatase inhibitors in breast cancer
1Academic Department of Biochemistry, Royal Marsden Hospital, London, U.K.
Abstract:
Over recent years highly potent, well-tolerated aromatase inhibitors have been developed, which essentially obliterate peripheral aromatase activity in postmenopausal women. Their role as the optimal second-line agents (post-tamoxifen) for the treatment of advanced breast cancer has recently been established in large comparative clinical trials. Their testing as adjuvant therapy is warranted, but their eventual application in this (or the prophylactic) setting will be dependent on the currently unknown effects of profound oestrogen deprivation on the physiology of postmenopausal women as well as on its efficacy. It is also possible that these new compounds could suppress oestrogen synthesis in premenopausal women, but the consequences on ovarian folliculogenesis might prevent their widespread use in this group of patients.
Insights
Highly effective aromatase inhibitors are now available for postmenopausal women with advanced breast cancer. Further research is needed to understand the effects of estrogen deprivation for adjuvant or prophylactic use.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Aromatase inhibitors (AIs) are potent drugs that block estrogen production.
- AIs are increasingly used for advanced breast cancer treatment in postmenopausal women.
- Clinical trials confirm AIs as effective second-line therapy after tamoxifen.
Purpose of the Study:
- To evaluate the established role of aromatase inhibitors in advanced breast cancer.
- To explore the potential of AIs in adjuvant and prophylactic settings.
- To investigate the physiological effects of estrogen deprivation in postmenopausal women.
Main Methods:
- Review of large comparative clinical trials on aromatase inhibitors.
- Analysis of current data on AI efficacy and safety.
- Consideration of potential impacts on postmenopausal physiology.
Main Results:
- Aromatase inhibitors are well-tolerated and highly effective in postmenopausal women.
- Their role as second-line treatment for advanced breast cancer is established.
- Efficacy and safety for adjuvant/prophylactic use remain under investigation.
Conclusions:
- Aromatase inhibitors represent a significant advancement in breast cancer therapy.
- Further studies are required to determine the long-term effects of estrogen deprivation.
- Potential use in premenopausal women is limited by effects on ovarian function.