Aromatase Inhibitors in Breast Cancer

• Published in: The New England journal of medicine Vol. 348; no. 24; pp. 2431 - 2442
• Main Authors: Smith, Ian E, Dowsett, Mitch
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12.06.2003
• Subjects: Androstenedione - chemistry; Antineoplastic agents; Antineoplastic Agents - adverse effects; Antineoplastic Agents - pharmacology; Antineoplastic Agents - therapeutic use; Aromatase - pharmacology; Aromatase Inhibitors; Biological and medical sciences; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - prevention & control; Breast Neoplasms - surgery; Chemotherapy; Chemotherapy, Adjuvant; Diet; Drug Therapy, Combination; Enzyme Inhibitors - adverse effects; Enzyme Inhibitors - pharmacology; Enzyme Inhibitors - therapeutic use; Enzymes; Estrogens; Female; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Medical sciences; Menopause; Pharmacology. Drug treatments; Plasma; Premenopause; Tumors; Womens health; Antineoplastic agent; Human; Benzotriazole derivatives; Enzyme; Anastrozole; Enzyme inhibitor; Estrogen synthase; Review; Malignant tumor; Exemestane; Mammary gland diseases; Chemotherapy; Vorozole; Treatment; Triazole derivatives; Female; Mammary gland; Non steroid compound; Letrozole; Bibliographic review
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMra023246

Until recently, tamoxifen, a nonsteroidal antiestrogen, was the mainstay of endocrine treatment of breast cancer. However, new aromatase inhibitors that are many times more potent and specific than the first such agent, aminoglutethimide, are changing the management of breast cancer in postmenopausal women. This review discusses the role of aromatase inhibitors such as letrozole, anastrozole, and exemestane in the treatment of breast cancer. The third-generation aromatase inhibitors provide novel approaches to the endocrine treatment of breast cancer. These drugs are effectively challenging tamoxifen, the previous gold standard of care, 1 – 13 for use in postmenopausal patients with estrogen-receptor–positive cancers, who make up the majority of patients with breast cancer. These agents are also being considered for use in chemoprevention, a strategy in which tamoxifen has already been shown to reduce the incidence of breast cancer. 14 , 15 In this article, we review the current role of aromatase inhibitors and assess their potential for clinical use. Other reviews that may be of interest to specialists are . . .