Aromatases inhibitors for breast cancer in menopausal patients

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Mehdi Afrit
Soumaya Laabidi
Khedija Meddeb
Hela Skhiri
Aymen Zayane
Hamouda Boussen

Abstract

Aims: To analyze the litterature data concerning the results of the main international randomized trials of adjuvant Aromarase Inhibitors (AI) in adjuvant setting for early breast cancer and the impact on daily practice in the management of breast cancer.
Methods: We selected through a litterature review 30 publications concerned the topic of AI
Results : They concerned the large ATAC, BIG, MA17 and IES concerning anastrozole, letrozole and exemestane . AI have been compared to tamoxifen in upfront of swich intents and showed a superiority to reduce, mortality rate, controlateral breast cancer risk, a better tolerance profile compared to tamoxifen and a sigificant benefit in term of disease-free survival. These results made a revolution in the adjuvant BC treatment, leading to the systematic use of upfront AI in menopaused patients.
Conclusion: Adjuvant hormonotherapy in menopaused patients is now based on AI and proved its superiority to tamoxifen in term of distant, controlateral risks reduction and disease-free survival, less for overall survival.

Keywords:

Breast cancer, inhibitors aromatase, hormone, post-menopausal

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References

  1. Piccart M, Dochy E, Cardoso F. News in the medical treatment of breast cancer. Bull Cancer 2003;90:46-52.
  2. Maalej M, Hentati D, Messai T et al. Breast cancer in Tunisia in 2004: a comparative clinical and epidemiological study. Bull Cancer 2008;95:5-9.
  3. Simpson ER. Sources of estrogen and their importance. J Steroid Biochem Mol Biol 2005;86 : 225-30.
  4. Spano J.P, Khayat D, Delozier T. Place des inhibiteurs de l'aromatase en situation adjuvante dans le cancer du sein. Bull Cancer 2004;91:239-43.
  5. Dridi. M, Astier A. Place des inhibiteurs de l'aromatase dans le traitement du cancer du sein: aspects pharmacologiques et cliniques. J Pharm Clin 2007;26:5-14.
  6. Smith IE, Dowsett M. Aromatase inhibitors in breast cancer. N Engl J Med 2003;348:2431-42.
  7. Baum M, Buzdar A, Cuzick J, et al. The ATAC (Arimidex, Tamoxifen alone or in combination) Trialists' Group. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen alone or in combination) trial efficacy and safety update analyses. Cancer 2003;98: 1802-10.
  8. Baum M, Budzar AU, Cuzick J, et al. ATAC Trialists' Group. Anastrozole alone or in combination with tamoxifene versus tamoxifene for adjuvant treatment of postmenopausal women with early breast cancer: first results of theATAC randomised trial. Lancet 2002;359: 2131-9.
  9. Cuzick J, Sestak I, Baum M, Buzdar A, Howell A, Dowsett M, Forbes JF; ATAC/LATTE investigators. Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the ATAC trial. Lancet Oncol. 2010;11:1135-41.
  10. Forbes JF, Cuzick J, Buzdar A, et al. ATAC Trialists' Group Effet of anastrazole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-months analysis of the ATAC trial. Lancet oncol 2008;9:45-53
  11. Giobbie-Hurder A, Price K, Gelber R. Design, conduct, and analyses of Breast International Group (BIG) 1-98: A randomized, double-blind, phase-III study comparing letrozole and tamoxifen as adjuvant endocrine therapy for postmenopausal women with receptor-positive, early breast cancer Clin Trials June 2009;6:272-87.
  12. Mouridsen H, Giobbie-Hurder A, Goldhirsch A, et al. The BIG 1-98 Collaborative Group Letrozole Alone or in Sequence as Adjuvant Therapy N Engl J Med 2009;361:766-76.
  13. Thürlimann B, Keshaviah A, Coates AS, et al. The Breast International Group (BIG) 1-98 Collaborative Group. A Comparison of Letrozole and Tamoxifen in Postmenopausal Women with Early Breast Cancer. N Engl J Med 2005;353:2747-57.
  14. Monnier A. Long-term efficacy and safety of letrozolefor the adjuvant treatment of early breast cancer in postmenopausal women: a review Therapeutics and Clinical Risk Management 2009;5:725-38.
  15. Coombes RC, Hall E, Gibson LJ, et al. Arandomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 2004;350:1081-92.
  16. Coombes RC, Paridaens RC, Jassem J, et al. First mature analysis of the Intergroup Exemestane Study. J Clin Oncol 2006;24:527.
  17. Boccardo F, Rubagotti A, Puntoni M, et al. Switching to anastrozole versus continued tamoxifen treatment of early breast cancer : preliminary results of the Italian tamoxifen anastrozole trial. J Clin Oncol 2005;23:5138-47.
  18. Jakesz R, Jonat W, Gnant M, et al. Switching of postmenopausal women with endocrine responsive early breast cancer to anastrozole after 2 years' adjuvant tamoxifen : combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 2005;366: 455-62.
  19. Saphner T, Tormey DC, Gray R. Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol 1996;14:2738-46
  20. Goss PE, Ingle JN, Martino S, et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early stage breast cancer. N Engl J Med 2003;349: 1793-802.
  21. Finn RS, Dering J, Ginther C, et al. ER+ PR- breast cancer defines a unique subtype of breast cancer tahat is driven by growth factor signaling and may be more likely to respond to EGFR targeted therapies. Am Soc Clin Oncol 2006.
  22. Bergerat J.P. Place actuelle des inhibiteurs de l'aromatase dans le traitement adjuvant des cancers du sein Reste-t-il des indications aux anti-oestrogènes de type tamoxifène? Presse Med 2007;36:333-40.
  23. Ingle JN, Tu D, Pater JL, et al. Duration of letrozole treatment and outcomes in the placebocontrolled NCIC CTG MA.17 extended adjuvant therapy trial. Breast Cancer Res Treat 2006;99:295-300.
  24. Tralongo P, Di Mari A, Ferrau F. Cognitive impairment, aromatase inhibitors, and age. J Clin Oncol 2005;23:42-3.
  25. Bonneterre J, Thurlimann B, Robertson JFR, et al. Anastrozole versus tamoxifen as first-line therapy for advanced breast cancer in 668 postmenopausal women: results of the Tamoxifen or Arimidex Randomized Group Efficacy and Tolerability study. J Clin Oncol 2000;18:3748-57
  26. Paridaens R, Dirix L, Lohrish C, et al. Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer. Ann Oncol 2003;14:1391-8.
  27. Lucchi-Angellier E. Hormonothérapies et cancers du sein : mise au point. Rev Med Interne 2001;22:1213-24
  28. Lonning PE, Geisler, Krag LE, et al. Effect of exemestane on bone: a randomized placebo controlled study in postmenopausal women with early breast cancer at low risk. Proc Am Soc Clin Oncol 2004;22:14.
  29. Lester J, Coleman R. Bone loss and the aromatase inhibitors. Br J Cancer 2005;9:16-22.
  30. Singh S, Cuzick J, Mesher D, Richmond B, Howell A. Effect of baseline serum vitamin D levels on aromatase inhibitors induced musculoskeletal symptoms:results from the IBIS-II, chemoprevention study using anastrozole. Breast Cancer Res Treat. 2012;132:625-9.