Appraising adjuvant aromatase inhibitor therapy

Edith A. Perez

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

Tamoxifen, once the gold standard adjuvant endocrine therapy for early breast cancer, is being challenged by third-generation aromatase inhibitors (AIs) that have demonstrated improved disease-free survival in a variety of adjuvant settings for early breast cancer. Tamoxifen and AIs have different safety profiles, which should allow physicians to begin to individualize treatment based on a patient's comorbidities and risk factors. Because of its properties as a partial estrogen agonist, tamoxifen has a positive effect on serum lipids and may confer a cardioprotective benefit, as well as a beneficial effect on bone health. However, tamoxifen increases the risk for endometrial cancer and cerebrovascular/thromboembolic events. In comparison, the major side effect of AIs is increased bone loss, which may heighten the risk for osteoporotic fractures and bone pain. Because of their superior efficacy and manageable side effects, AIs are a cost-effective alternative to tamoxifen, and clinical guidelines now embrace AIs as appropriate adjuvant therapy for hormone-sensitive early breast cancer. The anticipated results of ongoing trials will provide further insights into the long-term safety and application of AI therapy in the adjuvant setting.

Original languageEnglish (US)
Pages (from-to)1058-1069
Number of pages12
JournalOncologist
Volume11
Issue number10
DOIs
StatePublished - Nov 1 2006

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Keywords

  • Adjuvant therapy
  • Aromatase inhibitor
  • Breast cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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