Fulvestrant in the management of postmenopausal women with advanced, endocrine-responsive breast cancer

Catherine Oakman, Erica Moretti, Libero Santarpia, Angelo Di Leo

Research output: Contribution to journalArticlepeer-review


Fulvestrant is a pure estrogen antagonist that binds, blocks and downgrades the estrogen receptor (ER). Its unique mechanism of action is its antitumor activity after progression on prior endocrine therapy. Fulvestrant has shown activity in ER-dependent cells that are ligand independent. Fulvestrant has been approved at 250 mg/month for postmenopausal women with hormone-sensitive advanced breast cancer after progression or recurrence on antiestrogen therapy. The fulvestrant 500 mg regimen has just received approval by the EMA and the US FDA, supported by dose-dependent ER downregulation and the recent results of the clinical trial CONFIRM. Fulvestrant in combination with systemic lowering of estrogen has shown no improvement over fulvestrant alone. Combination therapy with inhibitors of growth factor signaling may have greater efficacy and is under exploration. To enhance the benefit of fulvestrant and improve outcomes for individuals with ER-positive breast cancer, greater understanding of resistance mechanisms is required. A key issue is identification of patients with ER-positive disease who retain sensitivity to antiestrogen therapy after progression on tamoxifen and/or aromatase inhibitors.

Original languageEnglish
Pages (from-to)173-186
Number of pages14
JournalFuture Oncology
Issue number2
Publication statusPublished - Feb 2011


  • breast cancer
  • endocrine resistance
  • endocrine therapy
  • estrogen receptor blockade
  • fulvestrant

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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