title: Endocrine therapy in epithelial ovarian cancer.
abstract: The estrogen receptor (ER) is expressed at high levels in many epithelial ovarian cancers (EOC) and represents a potential target for endocrine therapy. Both anti-estrogens and aromatase inhibitors have been evaluated in phase II clinical trials. Areas covered: We present an overview of the phase II and phase III trials of anti-estrogens (tamoxifen and fulvestrant) and aromatase inhibitors (letrozole, anastrazole and exemestane) undertaken in epithelial ovarian cancer identified through a Pubmed search. We describe predictive biomarkers that are being investigated to identify responsive cancers. Expert commentary: The efficacy of endocrine therapy in epithelial ovarian cancer is likely to be confined to histological subtypes with the highest ER expression while low grade serous ovarian cancer appears to be one subgroup with good sensitivity to these agents. The low toxicity profile of these agents is favourable although their use is unlicensed and the optimal setting undefined. Prospective clinical trials of endocrine agents in the early relapse and maintenance settings are urgently required to establish their definitive role in the management of epithelial ovarian cancer.
authors.affiliation: a Division of Pathology , Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital , Edinburgh , UK.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Langdon
authors.affiliation: b University of Edinburgh Cancer Research UK Centre, Institute of Genetics and Molecular Medicine, Western General Hospital , Edinburgh , UK.
authors.forename: Charlie
authors.initials: C
authors.lastname: Gourley
authors.affiliation: c Department of Surgery and Cancer , Ovarian Cancer Action Research Centre, Imperial College London , London , UK.
authors.forename: Hani
authors.initials: H
authors.lastname: Gabra
authors.affiliation: b University of Edinburgh Cancer Research UK Centre, Institute of Genetics and Molecular Medicine, Western General Hospital , Edinburgh , UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stanley
mesh_terms: D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D000077216:Carcinoma, Ovarian Epithelial; D004965:Estrogen Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011960:Receptors, Estrogen / Q000187:drug effects* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D004965:Estrogen Antagonists; D011960:Receptors, Estrogen
keywords: Ovarian cancer; anastrazole; estrogen receptor; fulvestrant; letrozole; tamoxifen