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https://www.readbyqxmd.com/read/28717399/fulvestrant-in-advanced-breast-cancer-evidence-to-date-and-place-in-therapy
#1
REVIEW
Katalin Boér
Breast cancer is a classical hormone-dependent tumour; therefore, endocrine therapy is the mainstay of treatment for hormone receptor-positive, human epidermal growth factor 2-negative advanced breast cancer. Until recently, classical endocrine agents such as tamoxifen, steroidal and nonsteroidal aromatase inhibitors and fulvestrant have been widely used in postmenopausal patients to treat locally advanced or metastatic disease. However, for patients with this subtype of breast cancer, the landscape of endocrine therapy is rapidly changing...
July 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28705409/clinical-benefit-and-risk-of-death-with-endocrine-therapy-in-ovarian-cancer-a-comprehensive-review-and-meta-analysis
#2
Laura Paleari, Sara Gandini, Nicoletta Provinciali, Matteo Puntoni, Nicoletta Colombo, Andrea DeCensi
BACKGROUND: Steroid hormones promote epithelial ovarian cancer (EOC) growth and their receptor expression is associated with disease outcome. Hormone therapy is frequently used in pretreated EOC, but the magnitude of activity overall and by specific agents or tumor characteristics is unknown. METHODS: Clinical Benefit Rates (CBR) and deaths from clinical trials of endocrine agents were meta-analyzed. Summary estimates of CBR (SCBR) and Odd Ratio for death (SOR) were calculated according with type of drug, ER and PgR status, platinum resistance, line of therapy, tumor grade and tamoxifen dose...
July 10, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28695299/adjuvant-ovarian-suppression-for-resected-breast-cancer-2017-critical-assessment
#3
EDITORIAL
Steven E Vogl
Currently available data supporting adjuvant ovarian function suppression for resected breast cancer in premenopausal women in addition to standard chemotherapy and tamoxifen are not persuasive, even though an ASCO guideline supports them. Available information from the key trial, called "SOFT," has only 5-year follow-up in a 15-year disease. It employs breast cancer events as an endpoint, rather than distant metastases, or better still, death from any cause. The small advantages reported to date may disappear when aromatase inhibitors are given after the occurrence of menopause in the control population...
July 10, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28680952/a-review-of-fulvestrant-in-breast-cancer
#4
REVIEW
Mark R Nathan, Peter Schmid
Fulvestrant is a selective estrogen receptor degrader that binds, blocks and degrades the estrogen receptor (ER), leading to complete inhibition of estrogen signaling through the ER. This review article further explains the mechanism of action of the drug and goes on to review the trials carried out to optimize its dosing. Multiple trials have been undertaken to compare fulvestrant with other endocrine treatments, and results have shown it to have similar efficacy to anastrozole, tamoxifen and exemestane at 250 mg every 28 days...
2017: Oncology and Therapy
https://www.readbyqxmd.com/read/28676319/impact-of-adjuvant-anti-estrogen-therapies-tamoxifen-and-aromatase-inhibitors-on-perioperative-outcomes-of-breast-reconstruction
#5
Raphaëlle Billon, Romain Bosc, Yazid Belkacemi, Elias Assaf, Mounia SidAhmed-Mezi, Barbara Hersant, Jean-Paul Meningaud
PURPOSE: Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend the duration of adjuvant treatment from 5 to 10 years. The association between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. However, while estrogens play a crucial role in wound healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative complications, including wound healing complications...
June 3, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28669713/adjuvant-endocrine-therapy-for-premenopausal-women-type-and-duration
#6
Prudence A Francis
The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) meta-analysis of randomized tamoxifen trials, found that women age <45 years with estrogen receptor-positive (ER+ve) breast cancer, allocated 5 years of adjuvant tamoxifen, have substantial long-term reduction of breast cancer recurrence. Breast cancer mortality was reduced by about one-third through the first 15 years. Increasing the duration of tamoxifen to 10 years can further reduce the risk of recurrence. For women age <45 years allocated 5 years of tamoxifen, the risk of contralateral breast cancer is halved over 15 years...
June 29, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28666422/the-role-of-hormonal-therapy-in-patients-with-relapsed-high-grade-ovarian-carcinoma-a-retrospective-series-of-tamoxifen-and-letrozole
#7
Angela George, Jennifer McLachlan, Nina Tunariu, Chiara Della Pepa, Cristina Migali, Martin Gore, Stan Kaye, Susana Banerjee
BACKGROUND: Hormonal therapy is used as a treatment option in high-grade ovarian carcinoma (HGOC), but the role and choice of treatment remains unclear. Agents used include tamoxifen and aromatase inhibitors. Our aim was to evaluate the efficacy of tamoxifen (T) and letrozole (L) in HGOC in clinical practice and investigate factors influencing clinical outcome. METHODS: A retrospective review of patients with relapsed HGOC treated with either tamoxifen or letrozole at the Royal Marsden Hospital between 2007 and 2012 was performed...
June 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28655486/vaginal-atrophy-in-breast-cancer-survivors-attitude-and-approaches-among-oncologists
#8
Nicoletta Biglia, Valentina Elisabetta Bounous, Marta D'Alonzo, Laura Ottino, Valentina Tuninetti, Elisabetta Robba, Tania Perrone
BACKGROUND: Vulvovaginal atrophy (VVA) is a relevant problem for breast cancer survivors (BCSs), in particular for those who receive aromatase inhibitors (AIs). We conducted a survey, to assess the attitude of oncologists toward the diagnosis and treatment of VVA in BCSs. MATERIALS AND METHODS: In 2015, 120 computer-assisted Web interviews were performed among breast oncologists. RESULTS: According to oncologists' perceptions, 60% of postmenopausal BCSs and 39...
May 19, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28651157/different-patterns-in-the-risk-of-newly-developed-fatty-liver-and-lipid-changes-with-tamoxifen-versus-aromatase-inhibitors-in-postmenopausal-women-with-early-breast-cancer-a-propensity-score-matched-cohort-study
#9
Namki Hong, Han Gyul Yoon, Da Hea Seo, Seho Park, Seung Il Kim, Joo Hyuk Sohn, Yumie Rhee
BACKGROUND: Management of metabolic complications of long-term adjuvant endocrine therapy in early breast cancer remained an unmet need. We aimed to compare the effects of tamoxifen (TMX) and aromatase inhibitors (AIs) on the risk of fatty liver in conjunction with longitudinal changes in the serum lipid parameters. METHODS: Among 1203 subjects who were taking adjuvant TMX or AI (anastrozole or letrozole) without fatty liver at baseline, those taking TMX or AI were 1:1 matched on the propensity score...
June 23, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28649660/how-do-we-increase-uptake-of-tamoxifen-and-other-anti-estrogens-for-breast-cancer-prevention
#10
Katherine D Crew, Kathy S Albain, Dawn L Hershman, Joseph M Unger, Shelly S Lo
Several randomized controlled trials of anti-estrogens, such as tamoxifen and aromatase inhibitors, have demonstrated up to a 50-65% decrease in breast cancerincidence among high-risk women. Approximately 15% of women, age 35-79 years, in the U.S. meet criteria for breast cancer preventive therapies, but uptake of these medications remain low. Explanations for this low uptake includelack of awareness of breast cancer risk status, insufficient knowledge about breast cancer preventive therapies among patients and physicians, and toxicity concerns...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28639031/opioid-use-among-female-breast-cancer-patients-using-different-adjuvant-endocrine-therapy-regimens
#11
Xi Tan, Tareq Fabian Camacho, Virginia T LeBaron, Leslie J Blackhall, Rajesh Balkrishnan
PURPOSE: To explore differences in opioid use across different adjuvant endocrine therapy (AET) regimens, factors associated with opioid use, and the impact of opioid use on overall survival in female breast cancer patients treated with AET. METHODS: This retrospective study analyzed 2006-2012 SEER-Medicare datasets, following patients for at least two years from the index date, defined as the first date they filled an AET prescription. The study included adult women with incident, primary, hormone-receptor-positive, stage I-III breast cancer...
June 21, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28635978/vaginal-testosterone-for-management-of-aromatase-inhibitor-related-sexual-dysfunction-an-integrative-review
#12
Emily A Lemke, Lydia T Madsen, Joyce E Dains
PROBLEM IDENTIFICATION: Women taking aromatase inhibitors (AIs) as part of the management of hormone receptor-positive breast cancer experience more symptoms of sexual dysfunction, including vaginal atrophy, as opposed to postmenopausal women and women treated with tamoxifen (Nolvadex®). Vaginal testosterone could be an alternative to estrogen, which is contraindicated in this population.
. LITERATURE SEARCH: A systematic review was completed by searching PubMed and Scopus databases...
May 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28610873/williams-syndrome-transcription-factor-wstf-acts-as-an-activator-of-estrogen-receptor-signaling-in-breast-cancer-cells-and-the-effect-can-be-abrogated-by-1%C3%AE-25-dihydroxyvitamin-d3
#13
Johan Lundqvist, Tove Kirkegaard, Anne-Vibeke Laenkholm, Anne Katrine Duun-Henriksen, Martin Bak, David Feldman, Anne E Lykkesfeldt
A majority of estrogen receptor positive (ER+) breast cancers are growth stimulated by estrogens. The ability to inhibit the ER signaling pathway is therefore of critical importance in the current treatment of ER+ breast cancers. It has been reported that 1α,25-dihydroxyvitamin D3 down-regulates the expression of the CYP19A1 gene, encoding the aromatase enzyme that catalyzes the synthesis of estradiol. Furthermore, 1α,25-dihydroxyvitamin D3 has also been reported to down-regulate the expression of estrogen receptor α (ERα), the main mediator of ER signaling...
June 10, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28585619/-palbociclib-combinations-as-new-therapeutic-strategies-in-the-treatment-of-hr-her2-advanced-breast-cancer
#14
Katalin Boér
Until recently, the only endocrine agents used to treat HR+/HER2- advanced breast cancers were tamoxifen, aromatase inhibitors and fulvestrant, although a substantial proportion of patients relapse on these standard therapies. Intensive research has been conducted to develop new strategies to overcome endocrine resistance and to enhance the efficacy of endocrine treatments by combining hormone therapy with other targeted treatment approaches. The development of selective CDK4/6 inhibitors and the introduction of palbociclib, the first molecule in this class in clinical practice, represent an important step in the treatment of HR+ advanced breast cancer...
June 6, 2017: Magyar Onkologia
https://www.readbyqxmd.com/read/28561717/addressing-the-survivorship-care-needs-of-patients-receiving-extended-cancer-treatment
#15
Paul B Jacobsen, Ryan D Nipp, Patricia A Ganz
Cancer survivorship care and research has typically focused on the health care needs of people with cancer following the acute phase of treatment. Work in this area, however, has faced challenges in identifying when treatment is complete for many forms of cancer. Acknowledging this challenge, the scope of survivorship research is often expanded to include patients also receiving maintenance or prophylactic therapy. Inherent in this expanded definition is the recognition that for many individuals, cancer is a chronic disease requiring extended treatment over many years...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28526959/adjuvant-tamoxifen-but-not-aromatase-inhibitor-therapy-decreases-serum-levels-of-the-wnt-inhibitor-dickkopf-1-while-not-affecting-sclerostin-in-breast-cancer-patients
#16
Andy Göbel, Jan D Kuhlmann, Theresa Link, Pauline Wimberger, Andrew J Browne, Martina Rauner, Lorenz C Hofbauer, Tilman D Rachner
PURPOSE: Endocrine therapies, including tamoxifen or aromatase inhibitors, are indispensable for the treatment of patients with estrogen receptor (ER)- and/or progesterone-positive breast cancer. Whereas tamoxifen displays partial ER agonistic effects in bone, aromatase inhibitors increase bone resorption and fracture risk. The Wnt inhibitors dickkopf-1 (DKK-1) and sclerostin negatively impact bone formation and are considered targets for the treatment of bone disorders. However, the effect of endocrine therapies on serum DKK-1 and sclerostin levels in patients with primary breast cancer remains elusive...
May 19, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28515111/racial%C3%A2-differences-in-adjuvant-endocrine-therapy-use-and-discontinuation-in-association-with-mortality-among-medicare-breast-cancer-patients-by-receptor-status
#17
Albert J Farias, Xianglin L Du
BACKGROUND: There are racial disparities in breast cancer mortality. Our purpose was to determine whether racial/ethnic differences in use and discontinuation of AET differed by hormone receptor status and whether discontinuation was associated with mortality. METHODS: We conducted a retrospective cohort study with SEER/Medicare dataset of women age 65 years or older diagnosed with stage I-III breast cancer in Medicare Part-D from 2007-2009, stratified by hormone receptor status...
May 17, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28494403/her2-status-predicts-for-upfront-ai-benefit-a%C3%A2-trans-aiog-meta-analysis-of-12-129-patients-from%C3%A2-atac-big-1-98-and-team-with-centrally-determined-her2
#18
John M S Bartlett, Ikhlaaq Ahmed, Meredith M Regan, Ivana Sestak, Elizabeth A Mallon, Patrizia Dell'Orto, Beat Thürlimann, Caroline Seynaeve, Hein Putter, Cornelis J H Van de Velde, Cassandra L Brookes, John F Forbes, Giuseppe Viale, Jack Cuzick, Mitchell Dowsett, Daniel W Rea
BACKGROUND: A meta-analysis of the effects of HER2 status, specifically within the first 2-3 years of adjuvant endocrine therapy, has the potential to inform patient selection for upfront aromatase inhibitor (AI) therapy or switching strategy tamoxifen followed by AI. The pre-existing standardisation of methodology for HER2 (immunohistochemistry/fluorescence in situ hybridization) facilitates analysis of existing data for this key marker. METHODS: Following a prospectively designed statistical analysis plan, patient data from 3 phase III trials Arimidex, Tamoxifen, Alone or in Combination Trial (ATAC), Breast International Group (BIG) 1-98 and Tamoxifen Exemestane Adjuvant Multicentre Trial (TEAM)] comparing an AI to tamoxifen during the first 2-3 years of adjuvant endocrine treatment were collected and a treatment-by-marker analysis of distant recurrence-free interval-censored at 2-3 years treatment - for HER2 status × AI versus tamoxifen treatment was performed to address the clinical question relating to efficacy of 'upfront' versus 'switch' strategies for AIs...
May 8, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28491147/a-clinical-guide-to-the-management-of-genitourinary-symptoms-in-breast-cancer-survivors-on-endocrine-therapy
#19
REVIEW
Mariana S Sousa, Michelle Peate, Sherin Jarvis, Martha Hickey, Michael Friedlander
There is increasing attention and concern about managing the adverse effects of adjuvant endocrine therapy for women with early breast cancer as the side effects of therapy influence compliance and can impair quality of life (QoL). Most side effects associated with tamoxifen (TAM) and aromatase inhibitors (AIs) are directly related to estrogen deprivation, and the symptoms are similar to those experienced during natural menopause but appear to be more severe than that seen in the general population. Prolonged estrogen deprivation may lead to atrophy of the vulva, vagina, lower urinary tract and supporting pelvic structures, resulting in a range of genitourinary symptoms that can in turn lead to pain, discomfort, impairment of sexual function and negatively impact on multiple domains of QoL...
April 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28467729/long-term-follow-up-of-the-intergroup-exemestane-study
#20
James P Morden, Isabel Alvarez, Gianfilippo Bertelli, Alan S Coates, Robert Coleman, Lesley Fallowfield, Jacek Jassem, Stephen Jones, Lucy Kilburn, Per E Lønning, Olaf Ortmann, Claire Snowdon, Cornelis van de Velde, Jørn Andersen, Lucia Del Mastro, David Dodwell, Stig Holmberg, Hanna Nicholas, Robert Paridaens, Judith M Bliss, R Charles Coombes
Purpose The Intergroup Exemestane Study, an investigator-led study of 4,724 postmenopausal patients with early breast cancer (clinical trial information: ISRCTN11883920), has previously demonstrated that a switch from adjuvant endocrine therapy after 2 to 3 years of tamoxifen to exemestane was associated with clinically relevant improvements in efficacy. Here, we report the final efficacy analyses of this cohort. Patients and Methods Patients who remained disease free after 2 to 3 years of adjuvant tamoxifen were randomly assigned to continue tamoxifen or switch to exemestane to complete a total of 5 years of adjuvant endocrine therapy...
May 3, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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