Clinical development of estrogen modulators for breast cancer chemoprevention in premenopausal vs. postmenopausal women.
Tamoxifen has proven to be beneficial in the chemoprevention of breast cancer in women at increased risk for the disease. Other compounds that mediate the estrogen pathway remain to be tested for clinical efficacy. The mechanism of action, efficacy, and dose response of the estrogen modulators is determined by the hormonal milieu of the host which should be considered in the early clinical trials for dose range finding studies and surrogate endpoint biomarker (SEB) evaluation. This review presents the hormonal effects to consider in the clinical testing of an agent in premenopausal vs. postmenopausal cohorts. Recommended SEBs that may be evaluated in Phase I/II clinical trials of estrogen modulators for breast cancer chemoprevention are presented.
Lawrence
J A
JA
Chemoprevention Branch, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland 20892-7322, USA.
Malpas
P B
PB
Sigman
C C
CC
Kelloff
G J
GJ
D047072:Aromatase Inhibitors; D001842:Bone and Bones / Q000502:physiology; D001943:Breast Neoplasms / Q000517:prevention & control*; D002319:Cardiovascular System / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004847:Epithelial Cells / Q000166:cytology / Q000473:pathology; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use*; D004967:Estrogens / Q000378:metabolism*; D005260:Female; D006801:Humans; D007211:Indoles / Q000378:metabolism; D007529:Isoflavones / Q000494:pharmacology; D050356:Lipid Metabolism; D008597:Menstrual Cycle; D010053:Ovary / Q000502:physiology; D010902:Pituitary Gland / Q000502:physiology; D017698:Postmenopause; D017697:Premenopause; D014599:Uterus / Q000502:physiology
D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D020847:Estrogen Receptor Modulators; D004967:Estrogens; D007211:Indoles; D007529:Isoflavones; C016517:indole-3-carbinol