Howell Anthony
CRUK Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, UK.
Trends Endocrinol Metab. 2005 Nov;16(9):420-8. doi: 10.1016/j.tem.2005.09.003. Epub 2005 Oct 6.
In recent years, new agents have challenged tamoxifen as the standard endocrine therapy for postmenopausal breast cancer. This article reviews developments with regard to the third-generation aromatase inhibitors (AIs)--anastrozole, letrozole and exemestane--and fulvestrant, the first of a new type of estrogen receptor antagonist that, unlike tamoxifen, has no partial agonist activity. The final results of the "Arimidex", Tamoxifen, Alone or in Combination (ATAC) trial, at a median follow-up of more than five years, and recent results from switching studies with anastrozole and exemestane, strengthen the position of these AIs as adjuvant treatment for hormone receptor-positive early breast cancer. Sequencing options for the future are also discussed because non-steroidal AIs are increasingly used early in the treatment sequence.
近年来，新型药物对他莫昔芬作为绝经后乳腺癌标准内分泌治疗的地位提出了挑战。本文综述了第三代芳香化酶抑制剂（AIs）——阿那曲唑、来曲唑和依西美坦——以及氟维司群的相关进展。氟维司群是新型雌激素受体拮抗剂中的首个药物，与他莫昔芬不同，它没有部分激动剂活性。“阿那曲唑、他莫昔芬单药或联合应用（ATAC）”试验的最终结果（中位随访时间超过五年）以及近期阿那曲唑和依西美坦转换研究的结果，强化了这些芳香化酶抑制剂作为激素受体阳性早期乳腺癌辅助治疗的地位。鉴于非甾体类芳香化酶抑制剂在治疗过程中越来越早地被使用，本文还讨论了未来的序贯治疗选择。
