Safety of aromatase inhibitors in the adjuvant setting

Edith A. Perez

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

The third-generation aromatase inhibitors (AIs) letrozole, anastrozole, and exemestane are replacing tamoxifen as adjuvant therapy in most postmenopausal women with early breast cancer. Although AIs have demonstrated superior efficacy and better overall safety compared with tamoxifen in randomized controlled trials, they may not provide the cardioprotective effects of tamoxifen, and bone loss may be a concern with their long-term adjuvant use. Patients require regular bone mineral density monitoring, and prophylactic bisphosphonates are being evaluated to determine whether they may protect long-term bone health. AIs decrease the risks of thromboembolic and cerebrovascular events compared with tamoxifen, and the overall rate of cardiovascular events in patients treated with AIs is within the range seen in age-matched, non-breast-cancer populations. AIs are also associated with a lower incidence of endometrial cancer and fewer vaginal bleeding/discharge events than tamoxifen. Compared with tamoxifen, the incidence of hot flashes is lower with anastrozole and letrozole but may be higher with exemestane. Generally, adverse events with AIs are predictable and manageable, whereas tamoxifen may be associated with life-threatening events in a minority of patients. Overall, the benefits of AIs over tamoxifen are achieved without compromising overall quality of life.

Original languageEnglish (US)
Pages (from-to)75-89
Number of pages15
JournalBreast Cancer Research and Treatment
Volume105
Issue number1 SUPPL.
DOIs
StatePublished - Oct 2007

Keywords

  • Adjuvant therapy
  • Aromatase inhibitors
  • Early breast cancer
  • Letrozole
  • Safety

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Safety of aromatase inhibitors in the adjuvant setting'. Together they form a unique fingerprint.

  • Cite this