TY - JOUR
T1 - Endocrine effects of aromatase inhibitors as adjuvant treatment in postmenopausal breast cancer patients
AU - Piccirillo, Maria Carmela
AU - Esposito, Giuseppe
AU - di Maio, Massimo
AU - Daniele, Gennaro
AU - Giordano, Pasqualina
AU - di Rella, Francesca
AU - Gravina, Adriano
AU - Labonia, Vincenzo
AU - Landi, Gabriella
AU - Nuzzo, Francesco
AU - Pacilio, Carmen
AU - Rossi, Emanuela
AU - Iaccarino, Mario
AU - Bryce, Jane
AU - de Feo, Gianfranco
AU - del Giudice, Antonia
AU - Fiore, Rosa
AU - Bonfanti, Gaetano
AU - Polese, Claudio
AU - Pasquale, Raffaella
AU - Signoriello, Simona
AU - Morabito, Alessandro
AU - Normanno, Nicola
AU - de Matteis, Andrea
AU - Vecchione, Aldo
AU - Perrone, Francesco
PY - 2011
Y1 - 2011
N2 - Aromatase inhibitors (AI) have become a cornerstone of adjuvant treatment for postmenopausal patients with estrogen receptor (ER)- positive early breast cancer. This chapter reviews the available evidence on endocrine effects of AI. Pharmacological activity of AI produces estradiol suppression, which represents the only known mechanism of action of such drugs, determining both side effects and antineoplastic efficacy. Overall, all third-generation AI (anastrozole, exemestane, letrozole) produce a significant suppression of estradiol levels, but there are some data suggesting that this effect might be less extensive than commonly thought and there are few comparative data to verify whether estradiol suppression varies with different AI. The most frequent side effects, related to estradiol suppression and reported in largescale clinical trials of adjuvant treatment with AI, are gynecological symptoms (less frequent and less severe than with tamoxifen, with the exception of vaginal dryness) and musculoskeletal symptoms (worse than with tamoxifen, which even has a positive effect on bone health). Disorders of lipid metabolism and cardiovascular side effects are less frequent. Among the latter, thromboembolism is less frequent with AI than with tamoxifen. There are many issues still of interest for clinical research on endocrine effects of AI. For example, it seems of utmost importance to verify whether endocrine effects might be predictive of AI efficacy and help to select the patients who can derive the greatest benefit from treatment with these drugs.
AB - Aromatase inhibitors (AI) have become a cornerstone of adjuvant treatment for postmenopausal patients with estrogen receptor (ER)- positive early breast cancer. This chapter reviews the available evidence on endocrine effects of AI. Pharmacological activity of AI produces estradiol suppression, which represents the only known mechanism of action of such drugs, determining both side effects and antineoplastic efficacy. Overall, all third-generation AI (anastrozole, exemestane, letrozole) produce a significant suppression of estradiol levels, but there are some data suggesting that this effect might be less extensive than commonly thought and there are few comparative data to verify whether estradiol suppression varies with different AI. The most frequent side effects, related to estradiol suppression and reported in largescale clinical trials of adjuvant treatment with AI, are gynecological symptoms (less frequent and less severe than with tamoxifen, with the exception of vaginal dryness) and musculoskeletal symptoms (worse than with tamoxifen, which even has a positive effect on bone health). Disorders of lipid metabolism and cardiovascular side effects are less frequent. Among the latter, thromboembolism is less frequent with AI than with tamoxifen. There are many issues still of interest for clinical research on endocrine effects of AI. For example, it seems of utmost importance to verify whether endocrine effects might be predictive of AI efficacy and help to select the patients who can derive the greatest benefit from treatment with these drugs.
KW - Adjuvant treatment
KW - Aromatase inhibitors
KW - Breast cancer
KW - Estradiol
KW - Postmenopausal
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M3 - Article
AN - SCOPUS:79956127908
VL - 3
JO - European journal of Clinical and Medical Oncology
JF - European journal of Clinical and Medical Oncology
SN - 1759-8958
IS - 1
ER -