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Tamoxifen aromatase

Irene E G van Hellemond, Ingeborg J H Vriens, Petronella G M Peer, Astrid C P Swinkels, Carolien H Smorenburg, Caroline M Seynaeve, Maurice J C van der Sangen, Judith R Kroep, Hiltje de Graaf, Aafke H Honkoop, Frans L G Erdkamp, Franchette W P J van den Berkmortel, Jos J E M Kitzen, Maaike de Boer, Wïlfred K de Roos, Sabine C Linn, Alexander L T Imholz, Vivianne C G Tjan-Heijnen
Background: Aromatase inhibitors (AIs) are given as adjuvant therapy for hormone receptor-positive breast cancer in postmenopausal women, also to those with chemotherapy-induced ovarian function failure. The current analysis reports on endocrine data of patients with chemotherapy-induced ovarian function failure who were included in the phase III DATA study assessing different durations of adjuvant anastrozole after tamoxifen. Methods: We identified all patients with chemotherapy-induced ovarian function failure...
December 1, 2017: Journal of the National Cancer Institute
Sabino De Placido, Ciro Gallo, Michelino De Laurentiis, Giancarlo Bisagni, Grazia Arpino, Maria Giuseppa Sarobba, Ferdinando Riccardi, Antonio Russo, Lucia Del Mastro, Alessio Aligi Cogoni, Francesco Cognetti, Stefania Gori, Jennifer Foglietta, Antonio Frassoldati, Domenico Amoroso, Lucio Laudadio, Luca Moscetti, Filippo Montemurro, Claudio Verusio, Antonio Bernardo, Vito Lorusso, Adriano Gravina, Gabriella Moretti, Rossella Lauria, Antonella Lai, Carmen Mocerino, Sergio Rizzo, Francesco Nuzzo, Paolo Carlini, Francesco Perrone
BACKGROUND: Uncertainty exists about the optimal schedule of adjuvant treatment of breast cancer with aromatase inhibitors and, to our knowledge, no trial has directly compared the three aromatase inhibitors anastrozole, exemestane, and letrozole. We investigated the schedule and type of aromatase inhibitors to be used as adjuvant treatment for hormone receptor-positive early breast cancer. METHODS: FATA-GIM3 is a multicentre, open-label, randomised, phase 3 trial of six different treatments in postmenopausal women with hormone receptor-positive early breast cancer...
February 23, 2018: Lancet Oncology
Hong Xiao, Xinyi Jiang, Cheng Chen, Alberto J Montero, Vakaramoko Diaby
BACKGROUND: Anti-estrogen (ER) endocrine therapy is an effective treatment strategy in reducing breast cancer mortality. This therapy has a better therapeutic index than chemotherapy but can still affect patients' quality of life (QOL) over time. OBJECTIVE: The objectives of this systematic review were to (1) describe QOL instruments used in ER-positive (ER+) non-metastatic breast cancer trials and (2) document the longitudinal effects of adjuvant endocrine therapy on the QOL of post-menopausal women with ER+ non-metastatic breast cancer...
February 22, 2018: PharmacoEconomics Open
Saamir A Hassan, Nicolas Palaskas, Peter Kim, Cezar Iliescu, Juan Lopez-Mattei, Elie Mouhayar, Rohit Mougdil, Kara Thompson, Jose Banchs, Syed Wamique Yusuf
PURPOSE OF REVIEW: Numerous chemotherapeutic agents have been associated with the development of ischemia and arterial thrombosis. As newer therapies have been developed to treat cancer, some of these chemotherapy drugs have been implicated in the development of vascular disease. In this review, we will summarize the most common chemotherapeutic drug classes that may play a role in the development of ischemic heart disease. RECENT FINDINGS: Angiogenesis inhibitors, alkylating agents, antimetabolites, antimicrotubules, and proteasome inhibitors have a number of cardiovascular toxicities...
February 8, 2018: Current Atherosclerosis Reports
Bo Lan, Fei Ma, Xiaoyu Zhai, Qiao Li, Shanshan Chen, Jiayu Wang, Ying Fan, Yang Luo, Ruigang Cai, Peng Yuan, Pin Zhang, Qing Li, Binghe Xu
Variants of the CYP2D6 gene may lead to a poor prognosis of tamoxifen (TAM)-treated patients. This study validated the association between the CYP2D6 genotype and outcomes of patients receiving TAM in adjuvant endocrine therapy. A total of 778 breast cancer patients who received adjuvant TAM (n=325) or aromatase inhibitors (AIs) (n=453) at the National Cancer Center were analyzed. Nine single nucleotide polymorphisms (SNPs) in the CYP2D6 gene were selected from online databases. The associations of each SNP genotype with disease-free survival (DFS) and clinicopathological characteristics were analyzed...
February 3, 2018: International Journal of Cancer. Journal International du Cancer
Lisa E Flaum, William J Gradishar
A majority of breast cancers are hormone receptor (HR) positive and are responsive to various types of hormone manipulation. Endocrine therapy is the preferred first-line therapy for patients with advanced estrogen receptor (ER) positive, HER2-negative breast cancer who do not have symptomatic visceral disease. Endocrine therapy is often continued in the second- and third-line setting, with chemotherapy deferred until tumor becomes endocrine therapy refractory and/or a visceral crisis in imminent. Therapeutic options vary based on clinical presentation and include single-agent therapies such as tamoxifen, aromatase inhibitors and fulvestrant, and combination therapies options...
2018: Cancer Treatment and Research
Tomás Reinert, Carlos H Barrios
We reviewed randomized phase II/III trials comparing first- or second-line endocrine therapy as monotherapy or in combination with targeted therapies for treatment of postmenopausal patients with hormone receptor-positive advanced breast cancer. First-line was defined as treatment for endocrine therapy-naïve advanced breast cancer or advanced disease treated with endocrine therapy in the adjuvant/neoadjuvant setting. Second-line was defined as endocrine therapy for advanced breast cancer following disease progression on endocrine therapy for advanced disease...
November 2017: Therapeutic Advances in Medical Oncology
Kerstin Wimmer, Stephanie Strobl, Michael Bolliger, Yelena Devyatko, Belgin Korkmaz, Ruth Exner, Florian Fitzal, Michael Gnant
Background: The benefit of 5 years of adjuvant endocrine therapy for women with hormone receptor-positive (HR+) breast cancer (BC) is beyond discussion. Nevertheless, the risk of recurrence of luminal BC persists for 15 years or more after diagnosis. Consequently, approaches of extended adjuvant therapy have been investigated in large clinical trials, with the ultimate aim of further reducing the risk of recurrence in patients with HR+ BC. Methods: A review of recently published trial data is presented to provide a solid basis for discussion...
November 2017: Therapeutic Advances in Medical Oncology
L Susan Taichman, Catherine H Van Poznak, Marita R Inglehart
AIM: The objectives are to compare responses of breast cancer (BCa) treatment groups (chemotherapy, tamoxifen, and aromatase inhibitors (AIs) to each other and a control regarding (a) subjective oral health, (b) oral health-related behaviors, (c) oral health-related concerns, and (d) communication with health care providers. METHODS: Survey data were collected from 140 postmenopausal BCa patients and 41 healthy postmenopausal control respondents. RESULTS: BCa patients reported on average more frequent mouth sores/mucositis (5-point scale with 1 = never: 1...
January 16, 2018: Special Care in Dentistry
G M H E Dackus, K Jóźwiak, G S Sonke, E van der Wall, P J van Diest, M Hauptmann, S Siesling, S C Linn
BACKGROUND: Prior randomised controlled trials on adjuvant hormonal therapy included HER2any patients; however, a differential effect of aromatase inhibitors (AIs) versus tamoxifen (TAM) may have been missed in ER+/HER2+ patients that comprise 7-15% of all breast cancer patients. In addition, a woman's hormonal microenvironment may influence sensitivity to TAM and AIs in the adjuvant setting, which changes during menopausal transition, a process that takes years. We studied the efficacy of AIs versus TAM in ER+/HER2+ breast cancer patients grouped by age at diagnosis as a proxy for menopausal status using treatment and outcome data from the nationwide population-based Netherlands Cancer Registry (NCR)...
February 2018: European Journal of Cancer
Parvin F Peddi
PURPOSE OF REVIEW: Hormone receptor (HR) positive breast cancer represents the vast majority of breast cancer cases. Treatment for these patients has been 5 years of endocrine therapy in the localized setting and endocrine therapy alone in the metastatic setting until progression of disease and switch to chemotherapy until quite recently. RECENT FINDINGS: The current article will review recent data on role of extended endocrine therapy with tamoxifen and aromatase inhibitors and adjuvant bisphosphonates in the localized disease setting...
February 2018: Current Opinion in Obstetrics & Gynecology
Joan M Neuner, Yushu Shi, Amanda L Kong, Sailaja Kamaraju, Elizabeth C Smith, Alicia J Smallwood, Purushottam W Laud, John A Charlson
PURPOSE: Although users of aromatase inhibitors have higher total fracture risk in some randomized trials, little is known about their risk outside of clinical trials or in older higher-risk cohorts. METHODS: In a population-based retrospective cohort study, we identified all older US Medicare D prescription drug insurance plan-enrolled women who had initial breast cancer surgery in 2006-2008 and began hormonal therapy (an aromatase inhibitor (AI) or tamoxifen) within the subsequent year...
December 15, 2017: Journal of Cancer Survivorship: Research and Practice
Rinath Jeselsohn
The recurrent ligand-binding domain ESR1 mutations are an important mechanism of endocrine resistance in estrogen receptor-positive (ER+) metastatic breast cancer. These mutations evolve under the selective pressure of endocrine treatments and are rarely found in treatment-naïve ER+ breast cancers. Preclinical studies showed that these mutations lead to ligand-independent activity facilitating resistance to aromatase inhibitors and relative resistance to tamoxifen and fulvestrant. Retrospective analyses of ESR1 mutations in baseline plasma circulating tumor DNA from clinical trials suggest that these mutations are prognostic of poor overall survival and predictive of resistance to aromatase inhibitors in metastatic disease...
October 2017: Breast Care
Sarah J O Nomura, Yi-Ting Hwang, Scarlett Lin Gomez, Teresa T Fung, Shu-Lan Yeh, Chiranjeev Dash, Laura Allen, Serena Philips, Leena Hilakivi-Clarke, Yun-Ling Zheng, Judy Huei-Yu Wang
PURPOSE: This project was undertaken to examine the association between dietary intake of soy or cruciferous vegetables and breast cancer treatment-related symptoms among Chinese-American (CA) and Non-Hispanic White (NHW) breast cancer survivors. METHODS: This cross-sectional study included 192 CA and 173 NHW female breast cancer survivors (stages 0-III, diagnosed between 2006 and 2012) recruited from two California cancer registries, who had completed primary treatment...
April 2018: Breast Cancer Research and Treatment
Alexander Tremont, Jonathan Lu, John T Cole
Background: Although breast cancer is still the second most common cause of cancer-related deaths, breast cancer mortality has been declining because of advances in the use of adjuvant therapies. Methods: We summarize clinical trials involving endocrine therapies used to treat early breast cancer and discuss their inception and recent advances. Results: Endocrine therapies such as tamoxifen have revolutionized the treatment of breast cancer, resulting in significant decreases in cancer-related mortality...
2017: Ochsner Journal
John A Charlson, Emily L McGinley, Ann B Nattinger, Joan M Neuner, Liliana E Pezzin
Background: Drug utilization under Medicare Part D varies significantly by geographic region. This study examined the extent to which geographic variation in Part D plan characteristics contributes to the variation in choice of initial endocrine therapy agent among women with incident breast cancer. Methods: Two-stage multivariate regression analyses were applied to the 16,541 women identified from Medicare claims as having incident breast cancer in 2006-2007. The first stage determined the effect of state of residence on the probability of having an aromatase inhibitor (AI), as opposed to tamoxifen, as initial endocrine therapy...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
Bent Ejlertsen, Birgitte Vrou Offersen, Jens Overgaard, Peer Christiansen, Maj-Britt Jensen, Niels Kroman, Ann Søgaard Knoop, Henning Mouridsen
BACKGROUND: Over the past 40 years the Danish Breast Cancer Cooperative Group (DBCG) has made significant contributions to improve outcome and to make treatment of patients with early breast cancer more tolerable through nationwide and international trials evaluating loco-regional and systemic treatments. These trials have been instrumental to establish standards for the treatment of early breast cancer. METHODS: The DBCG 82 trials had a global impact by documenting that the significant gain in loco-regional recurrence from postmastectomy radiation added to systemic therapy was associated with a reduction in distant recurrence and mortality in high-risk pre- and postmenopausal patients...
January 2018: Acta Oncologica
Anne E Lykkesfeldt, Benedikte R Iversen, Maj-Britt Jensen, Bent Ejlertsen, Anita Giobbie-Hurder, Birgit E Reiter, Tove Kirkegaard, Birgitte B Rasmussen
BACKGROUND: Cell culture studies have disclosed that the mitotic Aurora kinase A is causally involved in both tamoxifen and aromatase inhibitor resistant cell growth and thus may be a potential new marker for endocrine resistance in the clinical setting. MATERIAL AND METHODS: Archival tumor tissue was available from 1323 Danish patients with estrogen receptor (ER) positive primary breast cancer, who participated in the Breast International Group (BIG) 1-98 trial, comparing treatment with tamoxifen and letrozole and both in a sequence...
January 2018: Acta Oncologica
Hanna Aula, Tanja Skyttä, Suvi Tuohinen, Tiina Luukkaala, Mari Hämäläinen, Vesa Virtanen, Pekka Raatikainen, Eeva Moilanen, Pirkko-Liisa Kellokumpu-Lehtinen
AIM: To identify patients with breast cancer at risk for cardiotoxicity, we evaluated homoarginine (HA) behavior during adjuvant treatment. PATIENTS AND METHODS: Eighty-one patients received radiotherapy (RT) with or without endocrine treatment, and 19 received chemotherapy, RT and endocrine therapy. Serum HA, asymmetric dimethylarginine (ADMA) and high-sensitivity cardiac troponin T (hscTnT) were measured and echocardiography was performed before chemotherapy, and before and after RT...
December 2017: Anticancer Research
James E Frampton
A 1-month formulation of the gonadotrophin-releasing hormone agonist (GnRHa) triptorelin (Decapeptyl® ) has been approved in the EU as an adjuvant treatment in combination with tamoxifen or an aromatase inhibitor (AI), of endocrine-responsive, early-stage breast cancer in women at high risk of recurrence who are confirmed as premenopausal after completion of chemotherapy. This indication reflects the results of the 5-year SOFT and TEXT studies, especially SOFT, in which ovarian function suppression (OFS; mainly achieved with triptorelin) added to tamoxifen provided a significant benefit in the overall study population of premenopausal patients only after adjusting for prognostic factors...
December 2017: Drugs
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