The what, why and how of aromatase inhibitors: hormonal agents for treatment and prevention of breast cancer.
The what, why and how of aromatase inhibitors: hormonal agents for treatment and prevention of breast cancer.
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DOI：
10.1111/j.1742-1241.2007.01587.x
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发表时间：
2007-12
影响因子：
2.6
通讯作者：
Fabian CJ
中科院分区：
文献类型：
--
作者：
Fabian CJ
第三代芳香酶抑制剂（AI）阿那曲唑、阿司美坦和来曲唑已在很大程度上取代他莫昔芬，成为绝经后女性激素受体阳性乳腺癌的首选治疗药物。每年约有185，000例新的浸润性乳腺癌病例被诊断出来，其中至少有一半的妇女是绝经后妇女，有资格接受AI的辅助治疗。此外，AI目前正在大型随机试验中作为一级预防治疗进行测试，这些试验涉及数万名乳腺癌风险增加的女性。考虑到使用量，内科医生将越来越多地看到正在服用或考虑使用AI治疗的绝经后妇女。医生需要能够：（i）简要讨论使用选择性雌激素受体调节剂（如他莫昔芬或雷洛昔芬）与AI降低风险的利弊，以及（ii）识别和管理AI相关的不良事件。这篇综述的主要目的是帮助内科医生完成这两项任务。基于相关临床试验文献综述的专家意见。他莫昔芬和人工免疫制剂对于绝经后乳腺癌的辅助和新辅助治疗都是有效的;药物的最佳选择取决于患者和肿瘤的特征。两类药物的不良事件均可控。与他莫昔芬相关的不良事件包括子宫癌和血栓栓塞事件的风险增加，而与AI相关的阴道干燥、性欲丧失、肌肉骨骼疼痛和骨密度降低的发生率增加。在乳腺癌预防环境中进行的有希望的AI研究正在进行中。
The third-generation aromatase inhibitors (AIs) anastrozole, exemestane and letrozole have largely replaced tamoxifen as the preferred treatment for hormone receptor – positive breast cancer in postmenopausal women. Approximately 185,000 new cases of invasive breast cancer are diagnosed yearly, and at least half of these women are both postmenopausal and eligible for adjuvant therapy with AIs. In addition, AIs are currently being tested as primary prevention therapy in large randomised trials involving tens of thousands of women at increased risk for breast cancer. Given the volume of use, internists will increasingly see postmenopausal women who are taking or considering treatment with AIs. Physicians need to be able to: (i) briefly discuss the pros and cons of using a selective estrogen receptor modulator such as tamoxifen or raloxifene vs. an AI for risk reduction and (ii) recognise and manage AI-associated adverse events. The primary purpose of this review is to help internists with these two tasks. Expert opinion based on review of literature on relevant clinical trials. Both tamoxifen and AIs are effective for the adjuvant and neoadjuvant treatment of postmenopausal breast cancer; the optimal choice of drug is dependent on the characteristics of the patient and tumour. Adverse events with both drug classes are manageable. Adverse events associated with tamoxifen include increased risk of uterine cancers and thromboembolic events vs. an increased incidence of vaginal dryness, loss of libido, musculoskeletal pain and bone mineral density loss with AIs. Promising studies of AIs in the breast cancer prevention setting are ongoing.
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影响因子：
4.8
作者：
Blumenthal, RS;Baranowski, B;Dowsett, SA
通讯作者：
Dowsett, SA
影响因子：
6.2
作者：
Buzdar, Aman U.;Guastalla, Jean-Paul;Cuzick, Jack
通讯作者：
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影响因子：
45.3
作者：
Coates, Alan S.;Keshaviah, Aparna;Goldhirsch, Aron
通讯作者：
Goldhirsch, Aron
影响因子：
6.2
作者：
Chapurlat, RD;Garnero, P;Delmas, PD
通讯作者：
Delmas, PD
影响因子：
158.5
作者：
Barrett-Connor, Elizabeth;Mosca, Lori;Wenger, Nanette K.
通讯作者：
Wenger, Nanette K.