Extended adjuvant endocrine therapy of early breast cancer

被引:5
作者
Chowdhury, S [1 ]
Ellis, P [1 ]
机构
[1] Guys Hosp, Dept Med Oncol, London SE1 9RT, England
关键词
adjuvant therapy; anastrozole; aromatase inhibitors; early breast cancer; exemestane; letrozole; risk of recurrence;
D O I
10.1185/030079905X65619
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Women who are diagnosed with early breast cancer remain at considerable risk of recurrence over the next several decades, even if their tumors were small and lymph nodes were negative, and despite receiving standard adjuvant therapy. A majority of breast cancers are hormone (estrogen) receptor- positive and amenable to endocrine therapy, and for those women five years of the selective estrogen receptor modulator tamoxifen is standard therapy. Longer treatment of node-negative patients with tamoxifen may reduce survival benefits, however, possibly due to tamoxifen resistance and emerging receptor agonist activity of that drug. Aromatase inhibitors, which indirectly prevent estrogen stimulation of breast cancer by suppressing whole-body estrogen synthesis in post-menopausal women, are being investigated as alternative, or complementary, therapy to adjuvant tamoxifen in those women: as an alternative to five years of tamoxifen, sequenced with two to three years of tamoxifen, or following five years of tamoxifen. The strategy to extend the benefits of adjuvant therapy beyond a standard course of tamoxifen, using the aromatase inhibitor letrozole, was explored in a large trial, MA.17. Compared with women who received placebo, those who were treated with letrozole experienced a significant 43% reduction in their residual risk of recurrence. This effect was seen regardless of nodal status. Based on the long-term risk of most women with early breast cancer and the MA.17 trial results, the extended adjuvant letrozole may benefit many of those women who are disease-free after five years of tamoxifen. This review is based on a literature search of databases including MEDLINE/PubMed, San Antonio Breast Cancer Symposium, and the Annual Meeting of the American Society of Clinical Oncology, up to and including August 2005, with information selected for its relevance to adjuvant therapy of breast cancer with endocrine therapy only.
引用
收藏
页码:1985 / 1995
页数:11
相关论文
共 76 条
[1]  
*AM CANC SOC, CANC FACTS FIG 2004
[2]  
Baum M, 2002, LANCET, V359, P2131
[3]  
Baum M, 2003, Cancer, V98, P1802
[4]   Long-term exposure to tamoxifen induces hypersensitivity to estradiol [J].
Berstein, LM ;
Wang, JP ;
Zheng, H ;
Yue, W ;
Conaway, M ;
Santen, RJ .
CLINICAL CANCER RESEARCH, 2004, 10 (04) :1530-1534
[5]   Switching to anastrozole versus continued tamoxifen treatment of early breast cancer: Preliminary results of the Italian Tamoxifen Anastrozole trial [J].
Boccardo, F ;
Rubagotti, A ;
Puntoni, M ;
Guglielmini, P ;
Amoroso, D ;
Fini, A ;
Paladini, G ;
Mesiti, M ;
Romeo, D ;
Rinaldini, M ;
Scali, S ;
Porpiglia, M ;
Benedetto, C ;
Restuccia, N ;
Buzzi, F ;
Franchi, R ;
Massidda, B ;
Distante, V ;
Amadori, D ;
Sismondi, P .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (22) :5138-5147
[6]  
BOCCARDO F, 2005, 41 ANN M AM SOC CLIN
[7]  
Boccardo FM, 2005, J CLIN ONCOL, V23, p10S
[8]  
Bonneterre J, 2001, CANCER, V92, P2247, DOI 10.1002/1097-0142(20011101)92:9<2247::AID-CNCR1570>3.0.CO
[9]  
2-Y
[10]  
BRUFSKY A, 2004, 27 ANN SAN ANT BREAS