[Hormone therapy in breast cancer: the end of tamoxifen?]. 2005

Thierry Delozier
Centre François-Baclesse, avenue du Général-Harris, BP 3026, 14076 Caen Cedex. t.delozier@baclesse.fr

The rise of aromatase inhibitors changes our habits in hormonal treatment in breast cancer. In premenopausal women tamoxifen with ovarian suppression remains reference treatment although the succession of the two treatments has not been explored as far as treatment duration is concerned. In post menopausal women the use of AI in the first line treatment gives a greater chance of response and a longer response duration than tamoxifen with a good tolerance profile. When both treatments are used, total duration of endocrine therapy (time to chemotherapy) is significantly longer for patients who receive AI in first line than for patients who receive tamoxifen first. In adjuvant treatment, tamoxifen and ovarian suppression remain references in premenopausal patients; therefore trials using aromatase inhibitors with LH-RH agonists are running. In post menopausal women aromatase inhibitors are challenging tamoxifen. Three large trials proved their superiority over tamoxifen. In the adjuvant setting AI may represent a beneficial approach, they can be used up front or in sequence with tamoxifen. The ideal combination or sequence of therapies requires investigations. At last duration of hormonal treatment remains an open deal.

UI MeSH Term Description Entries
D008593 Menopause The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age. Change of Life, Female
D010053 Ovary The reproductive organ (GONADS) in female animals. In vertebrates, the ovary contains two functional parts: the OVARIAN FOLLICLE for the production of female germ cells (OOGENESIS); and the endocrine cells (GRANULOSA CELLS; THECA CELLS; and LUTEAL CELLS) for the production of ESTROGENS and PROGESTERONE. Ovaries
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D004958 Estradiol The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids. 17 beta-Estradiol,Estradiol-17 beta,Oestradiol,17 beta-Oestradiol,Aerodiol,Delestrogen,Estrace,Estraderm TTS,Estradiol Anhydrous,Estradiol Hemihydrate,Estradiol Hemihydrate, (17 alpha)-Isomer,Estradiol Monohydrate,Estradiol Valerate,Estradiol Valeriante,Estradiol, (+-)-Isomer,Estradiol, (-)-Isomer,Estradiol, (16 alpha,17 alpha)-Isomer,Estradiol, (16 alpha,17 beta)-Isomer,Estradiol, (17-alpha)-Isomer,Estradiol, (8 alpha,17 beta)-(+-)-Isomer,Estradiol, (8 alpha,17 beta)-Isomer,Estradiol, (9 beta,17 alpha)-Isomer,Estradiol, (9 beta,17 beta)-Isomer,Estradiol, Monosodium Salt,Estradiol, Sodium Salt,Estradiol-17 alpha,Estradiol-17beta,Ovocyclin,Progynon-Depot,Progynova,Vivelle,17 beta Estradiol,17 beta Oestradiol,Estradiol 17 alpha,Estradiol 17 beta,Estradiol 17beta,Progynon Depot
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013629 Tamoxifen One of the SELECTIVE ESTROGEN RECEPTOR MODULATORS with tissue-specific activities. Tamoxifen acts as an anti-estrogen (inhibiting agent) in the mammary tissue, but as an estrogen (stimulating agent) in cholesterol metabolism, bone density, and cell proliferation in the ENDOMETRIUM. ICI-46,474,ICI-46474,ICI-47699,Nolvadex,Novaldex,Soltamox,Tamoxifen Citrate,Tomaxithen,Zitazonium,Citrate, Tamoxifen,ICI 46,474,ICI 46474,ICI 47699,ICI46,474,ICI46474,ICI47699
D017024 Chemotherapy, Adjuvant Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment. Adjuvant Chemotherapy,Drug Therapy, Adjuvant,Adjuvant Drug Therapy
D017697 Premenopause The period before MENOPAUSE. In premenopausal women, the climacteric transition from full sexual maturity to cessation of ovarian cycle takes place between the age of late thirty and early fifty. Pre-Menopause,Pre-menopausal Period,Premenopausal Period,Period, Pre-menopausal
D047072 Aromatase Inhibitors Compounds that inhibit AROMATASE in order to reduce production of estrogenic steroid hormones. Aromatase Inhibitor,Inhibitor, Aromatase,Inhibitors, Aromatase

Related Publications

Thierry Delozier
October 1978, L'union medicale du Canada,
Thierry Delozier
January 1986, Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete,
Thierry Delozier
June 2005, Prescrire international,
Thierry Delozier
March 1987, The Journal of laboratory and clinical medicine,
Thierry Delozier
June 1979, Biochemical Society transactions,
Thierry Delozier
November 2000, The Lancet. Oncology,
Thierry Delozier
December 1983, Clinical oncology,
Thierry Delozier
January 1999, Advances in mind-body medicine,
Thierry Delozier
January 1993, Bulletin of the World Health Organization,
Thierry Delozier
June 1991, Annals of oncology : official journal of the European Society for Medical Oncology,
Copied contents to your clipboard!