Aromatase inhibitors: past, present and future in breast cancer therapy.
Estrogen has been implicated in promoting breast cancer in a majority of women. Endocrine therapy controlling estrogen production has been the guiding principle in treating breast cancer for more than a century. A greater understanding of this disease at a molecular level has led to the development of molecules that inhibit estrogen production by inhibiting the aromatase enzyme, that is the primary source of estrogen in postmenopausal women. This review examines the evolution of aromatase inhibitor (AI) based therapies over the past three decades. The third generation aromatase inhibitors (anastrozole, letrozole and exemestane), which have been found to be extremely specific and effective in an adjuvant/neoadjuvant/extended adjuvant setting are discussed from a biochemical and clinical perspective. A comprehensive discussion of the past, present, and future of aromatase inhibitors is conducted in this review.
Dutta
Udayan
U
Department of Cancer Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA. Udayan.Dutta@umassmed.edu
Pant
Kartikeya
K
D000616:Aminoglutethimide / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use; D000735:Androstenedione / Q000031:analogs & derivatives / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D017316:Fadrozole / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use
D000730:Androstadienes; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000616:Aminoglutethimide; D000735:Androstenedione; D000077289:Letrozole; D017316:Fadrozole; C056516:exemestane; C014594:formestane