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Extended adjuvant endocrine therapy of early breast cancer.
Curr Med Res Opin. 2005 Dec; 21(12):1985-95.CM

Abstract

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.

Authors+Show Affiliations

Chowdhury S
Department of Medical Oncology, Guy's Hospital, London, UK.
Ellis P
No affiliation info available

MeSH

Aromatase InhibitorsBreast NeoplasmsClinical Trials as TopicFemaleHumansNeoplasm Recurrence, LocalTamoxifen

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

16368050

Citation

Chowdhury, Simon, and Paul Ellis. "Extended Adjuvant Endocrine Therapy of Early Breast Cancer." Current Medical Research and Opinion, vol. 21, no. 12, 2005, pp. 1985-95.
Chowdhury S, Ellis P. Extended adjuvant endocrine therapy of early breast cancer. Curr Med Res Opin. 2005;21(12):1985-95.
Chowdhury, S., & Ellis, P. (2005). Extended adjuvant endocrine therapy of early breast cancer. Current Medical Research and Opinion, 21(12), 1985-95.
Chowdhury S, Ellis P. Extended Adjuvant Endocrine Therapy of Early Breast Cancer. Curr Med Res Opin. 2005;21(12):1985-95. PubMed PMID: 16368050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended adjuvant endocrine therapy of early breast cancer. AU - Chowdhury,Simon, AU - Ellis,Paul, PY - 2005/12/22/pubmed PY - 2006/2/4/medline PY - 2005/12/22/entrez SP - 1985 EP - 95 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 21 IS - 12 N2 - 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. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/16368050/Extended_adjuvant_endocrine_therapy_of_early_breast_cancer_ DB - PRIME DP - Unbound Medicine ER -