Breast cancer: Current and future endocrine therapies

Endocrine therapy forms a central modality in the treatment of estrogen receptor positive breast cancer. The routine use of 5years of adjuvant tamoxifen has improved survival rates for early breast cancer, and more recently has evolved in the postmenopausal setting to include aromatase inhibitors. T...

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Bibliographic Details
Published in:Molecular and cellular endocrinology 2014-01, Vol.382 (1), p.695-723
Main Authors: Palmieri, Carlo, Patten, Darren K., Januszewski, Adam, Zucchini, Giorgia, Howell, Sacha J.
Format: Article
Language:English
Subjects:
Adjuvants
Breast
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Cancer
Chemotherapy, Adjuvant
Clinical Trials as Topic
Endocrine therapy
Estrogens - therapeutic use
Female
Humans
Inhibitors
Neoplasm Metastasis
Pathways
Receptors, Estrogen - metabolism
Survival
Tamoxifen
Targeted therapy
Therapy
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Summary:Endocrine therapy forms a central modality in the treatment of estrogen receptor positive breast cancer. The routine use of 5years of adjuvant tamoxifen has improved survival rates for early breast cancer, and more recently has evolved in the postmenopausal setting to include aromatase inhibitors. The optimal duration of adjuvant endocrine therapy remains an active area of clinical study with recent data supporting 10years rather than 5years of adjuvant tamoxifen. However, endocrine therapy is limited by the development of resistance, this can occur by a number of possible mechanisms and numerous studies have been performed which combine endocrine therapy with agents that modulate these mechanisms with the aim of preventing or delaying the emergence of resistance. Recent trial data regarding the combination of the mammalian target of rapamycin (mTOR) inhibitor, everolimus with endocrine therapy have resulted in a redefinition of the clinical treatment pathway in the metastatic setting. This review details the current endocrine therapy utilized in both early and advanced disease, as well as exploring potential new targets which modulate pathways of resistance, as well as agents which aim to modulate adrenal derived steroidogenic hormones.
ISSN:0303-7207
1872-8057
DOI:10.1016/j.mce.2013.08.001