Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer

James N. Ingle, Steven Come, Matthew Ellis, Richard Santen, Mina Bissell, Rachel Schiff, Paul Goss

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The introduction of the nonsteroidal aromatase inhibitor (NS-AI) anastrozole as an alternative to tamoxifen for adjuvant therapy of women with resected hormone receptor-positive breast cancer has added a management category into which patients presenting with metastatic disease can be placed. There are now essentially three such categories: (a) tamoxifen sensitive (no prior AI); (b) tamoxifen resistant (no prior AI); and (c) NS-AI resistant (no prior tamoxifen). Well-conducted Phase III trials provide evidence for choosing first-line therapy for advanced disease in categories a and b. In tamoxifen-sensitive patients, one can choose either NS-AI, anastrozole, or letrozole. In tamoxifen-resistant patients, one can choose either of the NS-AIs, the steroidal AI exemestane, or the estrogen receptor down-regulator fulvestrant. The situation is quite different for patients in category c. There are no Phase III trials of agents in patients who have experienced disease progression on a NS-AI. Phase II data are available for exemestane and high-dose estrogens, and retrospective data are available for tamoxifen and fulvestrant. Additional clinical trials are needed to determine an optimal sequencing strategy.

Original languageEnglish (US)
JournalClinical Cancer Research
Volume10
Issue number1 II
DOIs
StatePublished - Jan 28 2004

Fingerprint

Tamoxifen
Aromatase Inhibitors
exemestane
Breast Neoplasms
letrozole
Therapeutics
Proxy
Estrogen Receptors
Disease Progression
Estrogens
Clinical Trials
Hormones

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ingle, J. N., Come, S., Ellis, M., Santen, R., Bissell, M., Schiff, R., & Goss, P. (2004). Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer. Clinical Cancer Research, 10(1 II). https://doi.org/10.1158/1078-0432.CCR-031200

Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer. / Ingle, James N.; Come, Steven; Ellis, Matthew; Santen, Richard; Bissell, Mina; Schiff, Rachel; Goss, Paul.

In: Clinical Cancer Research, Vol. 10, No. 1 II, 28.01.2004.

Research output: Contribution to journalArticle

Ingle, JN, Come, S, Ellis, M, Santen, R, Bissell, M, Schiff, R & Goss, P 2004, 'Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer', Clinical Cancer Research, vol. 10, no. 1 II. https://doi.org/10.1158/1078-0432.CCR-031200
Ingle, James N. ; Come, Steven ; Ellis, Matthew ; Santen, Richard ; Bissell, Mina ; Schiff, Rachel ; Goss, Paul. / Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer. In: Clinical Cancer Research. 2004 ; Vol. 10, No. 1 II.
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