Endocrine therapy in the preoperative setting and strategies to overcome resistance

Saranya Chumsri, Angela Brodie

Research output: Contribution to journalArticle

Abstract

Endocrine therapy remains the mainstay for treatment of hormone receptor-positive breast cancer in both adjuvant and metastatic settings. Due to the cytostatic property of endocrine therapy, cytotoxic chemotherapy is more commonly used for cytoreduction in preoperative setting to promote breast-conserving surgery. Nevertheless, recent clinical trials demonstrated that preoperative endocrine therapy can also be used to facilitate breast conservation in patients with locally advanced breast cancer, particularly in postmenopausal women with low proliferative tumors. Multiple markers have been shown to be predictive of endocrine responsiveness, including estrogen and progesterone receptor expression as well as other molecular profiles such as the 21-gene recurrence score assay and PAM-50 assay. The preoperative setting offers a unique situation to rapidly prioritize novel treatment combination and to identify the mechanisms of resistance. Several strategies to overcome resistance, including co-targeting other signaling pathways, particularly human epidermal growth factor receptor 2 (HER2), vascular endothelial growth factor receptor (VEGF), and PI3K/Akt/mTOR, are discussed in this review article.

Original languageEnglish (US)
Pages (from-to)181-189
Number of pages9
JournalCurrent Breast Cancer Reports
Volume3
Issue number4
DOIs
StatePublished - Dec 2011
Externally publishedYes

Fingerprint

Breast Neoplasms
Therapeutics
Vascular Endothelial Growth Factor Receptor
Segmental Mastectomy
Cytostatic Agents
Progesterone Receptors
Phosphatidylinositol 3-Kinases
Estrogen Receptors
Breast
Clinical Trials
Hormones
Recurrence
Drug Therapy
Genes
Neoplasms
human ERBB2 protein

Keywords

  • Aromatase inhibitors
  • Breast cancer
  • Neoadjuvant

ASJC Scopus subject areas

  • Oncology

Cite this

Endocrine therapy in the preoperative setting and strategies to overcome resistance. / Chumsri, Saranya; Brodie, Angela.

In: Current Breast Cancer Reports, Vol. 3, No. 4, 12.2011, p. 181-189.

Research output: Contribution to journalArticle

@article{2c6528fdbbfb4c44b3efe6f90a9b2ec2,
title = "Endocrine therapy in the preoperative setting and strategies to overcome resistance",
abstract = "Endocrine therapy remains the mainstay for treatment of hormone receptor-positive breast cancer in both adjuvant and metastatic settings. Due to the cytostatic property of endocrine therapy, cytotoxic chemotherapy is more commonly used for cytoreduction in preoperative setting to promote breast-conserving surgery. Nevertheless, recent clinical trials demonstrated that preoperative endocrine therapy can also be used to facilitate breast conservation in patients with locally advanced breast cancer, particularly in postmenopausal women with low proliferative tumors. Multiple markers have been shown to be predictive of endocrine responsiveness, including estrogen and progesterone receptor expression as well as other molecular profiles such as the 21-gene recurrence score assay and PAM-50 assay. The preoperative setting offers a unique situation to rapidly prioritize novel treatment combination and to identify the mechanisms of resistance. Several strategies to overcome resistance, including co-targeting other signaling pathways, particularly human epidermal growth factor receptor 2 (HER2), vascular endothelial growth factor receptor (VEGF), and PI3K/Akt/mTOR, are discussed in this review article.",
keywords = "Aromatase inhibitors, Breast cancer, Neoadjuvant",
author = "Saranya Chumsri and Angela Brodie",
year = "2011",
month = "12",
doi = "10.1007/s12609-011-0056-2",
language = "English (US)",
volume = "3",
pages = "181--189",
journal = "Current Breast Cancer Reports",
issn = "1943-4588",
publisher = "Current Science, Inc.",
number = "4",

}

TY - JOUR

T1 - Endocrine therapy in the preoperative setting and strategies to overcome resistance

AU - Chumsri, Saranya

AU - Brodie, Angela

PY - 2011/12

Y1 - 2011/12

N2 - Endocrine therapy remains the mainstay for treatment of hormone receptor-positive breast cancer in both adjuvant and metastatic settings. Due to the cytostatic property of endocrine therapy, cytotoxic chemotherapy is more commonly used for cytoreduction in preoperative setting to promote breast-conserving surgery. Nevertheless, recent clinical trials demonstrated that preoperative endocrine therapy can also be used to facilitate breast conservation in patients with locally advanced breast cancer, particularly in postmenopausal women with low proliferative tumors. Multiple markers have been shown to be predictive of endocrine responsiveness, including estrogen and progesterone receptor expression as well as other molecular profiles such as the 21-gene recurrence score assay and PAM-50 assay. The preoperative setting offers a unique situation to rapidly prioritize novel treatment combination and to identify the mechanisms of resistance. Several strategies to overcome resistance, including co-targeting other signaling pathways, particularly human epidermal growth factor receptor 2 (HER2), vascular endothelial growth factor receptor (VEGF), and PI3K/Akt/mTOR, are discussed in this review article.

AB - Endocrine therapy remains the mainstay for treatment of hormone receptor-positive breast cancer in both adjuvant and metastatic settings. Due to the cytostatic property of endocrine therapy, cytotoxic chemotherapy is more commonly used for cytoreduction in preoperative setting to promote breast-conserving surgery. Nevertheless, recent clinical trials demonstrated that preoperative endocrine therapy can also be used to facilitate breast conservation in patients with locally advanced breast cancer, particularly in postmenopausal women with low proliferative tumors. Multiple markers have been shown to be predictive of endocrine responsiveness, including estrogen and progesterone receptor expression as well as other molecular profiles such as the 21-gene recurrence score assay and PAM-50 assay. The preoperative setting offers a unique situation to rapidly prioritize novel treatment combination and to identify the mechanisms of resistance. Several strategies to overcome resistance, including co-targeting other signaling pathways, particularly human epidermal growth factor receptor 2 (HER2), vascular endothelial growth factor receptor (VEGF), and PI3K/Akt/mTOR, are discussed in this review article.

KW - Aromatase inhibitors

KW - Breast cancer

KW - Neoadjuvant

UR - http://www.scopus.com/inward/record.url?scp=82355175322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=82355175322&partnerID=8YFLogxK

U2 - 10.1007/s12609-011-0056-2

DO - 10.1007/s12609-011-0056-2

M3 - Article

AN - SCOPUS:82355175322

VL - 3

SP - 181

EP - 189

JO - Current Breast Cancer Reports

JF - Current Breast Cancer Reports

SN - 1943-4588

IS - 4

ER -