Aromatase Inhibitors: Indications for Breast Cancer Therapy
Source: American Journal of Cancer, Volume 1, Number 2, 1 February 2002 , pp. 93-100(8)
Publisher: Adis International
Abstract:Endocrine treatment is at the core of therapies against early and advanced breast cancer. Modulators of the estrogen receptor have monopolized the field, offering durable clinical responses with an excellent tolerability profile. The benefits of endocrine therapy, however, are limited to estrogen receptor positive patients. A newer class of drugs, the aromatase inhibitors, have gradually emerged as an alternative endocrine therapy. The advent of third-generation aromatase inhibitors, also known as selective aromatase inhibitors (SAIs), has revolutionized the treatment options available to clinicians and patients. Their potency, increased specificity and overall efficacy have established them as second-line hormonal agents, thus replacing megestrol acetate. A number of large randomized clinical trials have looked into their potential role as first-line agents in advanced breast cancer. These data illustrate that both anastrozole and letrozole have better antitumor activity and better tolerability profiles compared to tamoxifen. In addition, the initial results of a large adjuvant trial of anastrozole versus tamoxifen showed that patients treated with anastrozole had significantly fewer disease recurrences compared with tamoxifen. The overall tolerability profile of anastrozole was also favorable compared to tamoxifen. This review will focus on the latest available clinical data on SAIs as well as the ongoing clinical trials exploring the role of SAIs in the adjuvant setting.
Document Type: Leading Article
Publication date: 2002-02-01