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Title

THE POTENCY AND CLINICAL EFFICACY OF AROMATASE INHIBITORS IN BREAST CANCER HORMONAL THERAPY

Writers

 NAJAFI SAFA

Pages

 Start Page 55 | End Page 68

Abstract

 Background: The strategy of using ESTROGEN suppression to treat BREAST CANCER led to the development of AROMATASE INHIBITORs, including the third-generation nonsteroidal compounds ANASTROZOLE and LETROZOLE, and the steroidal compound EXEMESTANE.Material and Methods: AROMATASE INHIBITORs potently inhibit aromatase activity and also suppress ESTROGEN levels in plasma and tissue. In clinical studies in postmenopausal women with BREAST CANCER, third-generation AROMATASE INHIBITORs were shown superior to tamoxifen for the treatment of metastatic disease. Studies of adjuvant therapy with AROMATASE INHIBITORs include (i) head-to-head studies of 5 years of the AROMATASE INHIBITOR versus 5 years of tamoxifen monotherapy; (ii) sequential therapy of 2–3 years of tamoxifen followed by an AROMATASE INHIBITOR (or the opposite sequence) versus 5 years of tamoxifen onotherapy; (iii) extended therapy with an AROMATASE INHIBITOR after 5 years of tamoxifen; and (iv) sequential therapy with an AROMATASE INHIBITOR versus AROMATASE INHIBITOR monotherapy.Results and Conclusion: Recent results from the Arimidex, Tamoxifen, Alone or in Combination and Breast International Group 1-98 trials advocate using an AROMATASE INHIBITOR upfront. This article examines the clinical data with AROMATASE INHIBITORs, following a brief summary of their pharmacology.

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