Aromatase inhibitors in breast cancer: an update.
BACKGROUND
Tamoxifen has been the endocrine treatment of choice for patients with breast cancer. The development of selective aromatase inhibitors has offered an alternative management approach for patients in whom a hormonal approach is indicated.


METHODS
The authors reviewed reports in which aromatase inhibitors were compared with tamoxifen for the treatment of metastatic disease, as well as information pertinent to their use as adjuvant therapy.


RESULTS
Both nonsteroidal (anastrozole and letrozole) and steroidal (exemestane) aromatase inhibitors for metastatic disease appear to provide superior efficacy and a better toxicity profile in first- and second-line treatment of metastatic disease than tamoxifen. Early results from the ATAC trial suggest anastrozole is superior to tamoxifen for disease-free survival, particularly in receptor-positive patients, and in reducing the incidence of contralateral breast cancer.


CONCLUSIONS
Aromatase inhibitors have important roles in optimal management of postmenopausal patients with hormone-responsive metastases in both the adjuvant and advanced-disease settings.
Lake
Diana E
DE
Division of Solid Tumor Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. laked@mskcc.org
Hudis
Clifford
C
D000616:Aminoglutethimide / Q000737:chemistry / Q000627:therapeutic use; D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000737:chemistry / Q000627:therapeutic use; D047072:Aromatase Inhibitors; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000517:prevention & control; D017024:Chemotherapy, Adjuvant / Q000379:methods; D004791:Enzyme Inhibitors / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D018734:Genes, erbB-2 / Q000187:drug effects; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000737:chemistry / Q000627:therapeutic use; D013629:Tamoxifen / Q000627:therapeutic use; D014230:Triazoles / Q000737:chemistry / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000616:Aminoglutethimide; D000077384:Anastrozole; D000077289:Letrozole