[Modern approaches to hormone therapy of breast cancer as a reflection of pathogenesis of the disease].
Experimental and epidemiological studies have pointed to a major role of estrogens in the pathogenesis of human breast cancer. The Oxford meta-analysis (1998) once again confirmed the efficacy of antiestrogens (tamoxifen) as adjuvant therapy. We need to know whether the new non-steroid antiestrogens (idoxifen, droloxifen and TAT-59) and selective estrogen receptor modulator (raloxifen), whith preclinical characteristics better than those of tamoxifen will be more efficient clinically. Large-scale trials to compare the new drugs with tamoxifen are under way. Faslodex, a pure antiestrogen, looks highly promising, too. Zoladex, a luteinising hormone-releasing hormone agonist, is looking as a better choice than ovariectomy or irradiation of the pelvis for ovarian ablation in premenopausal breast cancer. New aromatase inhibitors are more efficient than progestins and much safer than aminoglutethimide. It has been shown recently that these inhibitors keep metastatic breast cancer at bay longer, and with longer survival. The non-steroid inhibitors (anastrozole and letrozole) and the steroid oral drug exemestane are undergoing clinical trials as means of adjuvant treatment of breast cancer. The trial of arimidex and tamoxifen administered alone or in combination (ATAC) is unique since it is using a combination of tamoxifen and an aromatase inhibitor (anastrozole). New methods of endocrine therapy have resulted in less toxic and more convenient procedures. Also, longer therapeutic effects and survival are becoming more apparent.
Semiglazov
V P
VP
N.N. Petrov Research Institute of Oncology, Ministry of Health of the RF, St. Petersburg.
D001943:Breast Neoplasms / Q000188:drug therapy*; D020847:Estrogen Receptor Modulators / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015201:Meta-Analysis as Topic; D011960:Receptors, Estrogen / Q000187:drug effects
D020847:Estrogen Receptor Modulators; D011960:Receptors, Estrogen