title: Potential role of bone-directed therapy on the superiority of aromatase inhibitors over tamoxifen.
abstract: Aromatase inhibitors (AIs) are the current standard of care in postmenopausal women with hormone-responsive breast cancer in adjuvant setting due to their superiority over tamoxifen, in terms of disease-free survival. It is clear that AIs result in bone loss during the course of the treatment and many patients need to receive bisphosphonates and vitamin D supplementation during AI treatment. Emerging evidence shows that bisphosphonates have antitumor effects. In addition, the beneficial effects of vitamin D supplementation on reducing breast cancer incidence and recurrence have recently been published. Thus, could the superiority of AIs over tamoxifen be related to increased need of bisphosphonate use and vitamin D supplementation? Although, at present, there is no concrete evidence of the impact of bone-directed therapy on the improved disease-free survival with AI compared to tamoxifen, we can not disregard this possibility.
authors.affiliation: Section of Medical Oncology, Department of Internal Medicine, Yeditepe University Hospital, Istanbul, Turkey. basakou@yahoo.com
authors.forename: Basak
authors.initials: B
authors.lastname: Oyan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D004164:Diphosphonates / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced* / Q000188:drug therapy*; D017698:Postmenopause; D055502:Secondary Prevention; D013629:Tamoxifen / Q000627:therapeutic use*; D014807:Vitamin D / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D004164:Diphosphonates; D013629:Tamoxifen; D014807:Vitamin D