Existing and emerging endocrine therapies for breast cancer

    Authors

    K. H. Dow

    Abbreviated Journal Title

    Cancer Nurs.

    Keywords

    metastatic breast cancer; endocrine therapy; tamoxifen; megestrol; aromatase inhibitors; estrogen receptor down-regulators; fulvestrant; ORAL AROMATASE INHIBITOR; FIRST-LINE THERAPY; POSTMENOPAUSAL WOMEN; MEGESTROL-ACETATE; RANDOMIZED TRIAL; PURE ANTIESTROGEN; REPLACEMENT; THERAPY; ADJUVANT TAMOXIFEN; CLINICAL-TRIALS; ANASTROZOLE; Oncology; Nursing

    Abstract

    Endocrine therapy is first-line therapy for patients with estrogen receptor-positive or progesterone receptor-positive metastatic breast cancer. Commonly used endocrine therapies are tamoxifen, megestrol acetate, and aromatase inhibitors. Although tamoxifen and megestrol acetate have a favorable therapeutic profile, there are risks associated with these agents. With tamoxifen, the partial agonist property can lead to thromboembolic events. An important adverse event of megestrol acetate is weight gain and fluid retention in some patients. The aromatase inhibitors are currently used as second-line therapy after tamoxifen failure. A recent study showed that anastrozole, an aromatase inhibitor, is as effective or even superior to tamoxifen when used as a first-line therapy. However, not all patients will respond to currently available therapies. A new class of drug, the estrogen receptor downregulators, has been developed. Fulvestrant, the first agent in this new class, not only induces the degradation of the estrogen receptor but also is an estrogen antagonist; further, its lack of agonist activity provides a better safety profile. Two phase III trials have proven that fulvestrant is at least as effective as anastrozole in postmenopausal women with advanced breast cancer. Fulvestrant is an effective and safe endocrine therapy for postmenopausal women who have failed prior endocrine therapy.

    Journal Title

    Cancer Nursing

    Volume

    25

    Issue/Number

    2

    Publication Date

    1-1-2002

    Document Type

    Article

    Language

    English

    First Page

    6S

    Last Page

    11S

    WOS Identifier

    WOS:000174779400002

    ISSN

    0162-220X

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