title: Effects of fulvestrant alone or combined with different steroids in human breast cancer cells in vitro.
abstract: OBJECTIVE
  Fulvestrant is an estrogen receptor (ER) antagonist that binds, blocks and degrades the estrogen receptor and is currently used in adjuvant treatment in postmenopausal women with ER-positive breast cancer as an alternative for tamoxifen. As an antagonist, it may induce or aggravate climacteric symptoms. In order to alleviate these symptoms, one could consider hormone therapy. The objective of this study was to analyze the effect of fulvestrant alone or in combination with different steroids in human breast cancer cells in vitro, and to demonstrate whether these steroids will compromise the efficacy of fulvestrant in ER-positive breast cancer cells.
  
  
  METHODS
  We performed experiments in vitro with various hormone therapy preparations (estradiol (E2), dihydrodydrogesterone (DHD) and tibolone) at a concentration of 10(-6) mol/l alone or combined with fulvestrant in different breast cancer cell lines, ER-positive and ER-negative. After an incubation of 144 h, proliferation and apoptosis were measured. The first was measured by quantification of the expression of cyclin D1 mRNA, the latter by the Nicoletti fragmentation assay.
  
  
  RESULTS
  This in vitro study revealed clear differences in results when various hormone therapy preparations, alone or combined with fulvestrant, are added to ER-positive and ER-negative breast cancer cell lines.
  
  
  CONCLUSIONS
  Our study demonstrated that fulvestrant, an ER antagonist used in the treatment of ER-positive breast cancer, combined with E2 and DHD or in combination with tibolone, is not compromised in its efficacy in inducing apoptosis in ER-positive breast cancer cell lines in vitro.
authors.affiliation: Department of Obstetrics, Twente Hospital Group, Enschede, The Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: Jansen
authors.forename: H R
authors.initials: HR
authors.lastname: Franke
authors.forename: F
authors.initials: F
authors.lastname: Wolbers
authors.forename: M
authors.initials: M
authors.lastname: Brinkhuis
authors.forename: I
authors.initials: I
authors.lastname: Vermes
mesh_terms: D017209:Apoptosis / Q000187:drug effects*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D045744:Cell Line, Tumor; D049109:Cell Proliferation / Q000187:drug effects*; D019938:Cyclin D1 / Q000378:metabolism; D004394:Dydrogesterone / Q000031:analogs & derivatives / Q000494:pharmacology; D004958:Estradiol / Q000031:analogs & derivatives* / Q000494:pharmacology; D004965:Estrogen Antagonists / Q000494:pharmacology*; D020847:Estrogen Receptor Modulators / Q000494:pharmacology; D004967:Estrogens / Q000494:pharmacology; D005260:Female; D000077267:Fulvestrant; D020249:Hormone Replacement Therapy; D006801:Humans; D066298:In Vitro Techniques; D009652:Norpregnenes / Q000494:pharmacology; D011372:Progestins / Q000494:pharmacology; D012333:RNA, Messenger / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism
chemical_list: C514239:20-alpha-dihydrodydrogesterone; D004965:Estrogen Antagonists; D020847:Estrogen Receptor Modulators; D004967:Estrogens; D009652:Norpregnenes; D011372:Progestins; D012333:RNA, Messenger; D011960:Receptors, Estrogen; D019938:Cyclin D1; D000077267:Fulvestrant; D004958:Estradiol; D004394:Dydrogesterone; C027385:tibolone