Current limits of knowledge in adjuvant and neoadjuvant endocrine therapy of breast cancer: the need for more clinical research.
Adjuvant endocrine therapy following surgical resection of early, endocrine sensitive breast cancer has proven benefits in reducing risk of recurrence and death, as demonstrated in many mature well controlled clinical trials. The introduction of new endocrine therapies as potential alternatives to tamoxifen or ovarian ablation and the incorporation of neoadjuvant endocrine therapy into the overall management strategy continue to provide exciting challenges for clinical research. In this article the focus is on as yet unanswered questions pertinent to adjuvant or neoadjuvant endocrine therapy for breast cancer. In the process, we broadly outline the current limits of knowledge as we understand it. Many relevant and current clinical trials are ongoing and a list of these with contact details or references are provided. Definitive data is urgently needed in many areas and, when available, will provide important evidence on which the management of breast cancer patients in future can be based. Participation in relevant clinical trials is vital for future progress.
Academic Office, Edinburgh Breast Unit, Western General Hospital, Edinburgh, Scotland EH4 2XU, UK.
R L
RL
Hayward
J M
JM
Dixon
D000328:Adult; D000367:Age Factors; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage*; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D020847:Estrogen Receptor Modulators; D013629:Tamoxifen