Oncology Department, Hospital Torrecardenas, Almeria, Spain.
Adv Ther. 2011 Sep;28 Suppl 6:66-84. doi: 10.1007/s12325-011-0039-8. Epub 2011 Sep 16.
The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP 2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option.
芳香化酶抑制剂（AI）的引入导致了早期乳腺癌治疗方法的改变。在本文中，我们分析了包括 ATAC、BIG 1-98、TEAM、MA-17、NSABP B-33 和 ABSCG-6 研究在内的最相关研究。绝经后激素受体阳性的早期乳腺癌患者应接受 AI 治疗 5 年。对于已开始使用他莫昔芬（TAM）的患者，也建议改用 AI 完成 5 年治疗。延长辅助治疗研究的结果建议在标准 TAM 治疗完成后使用 AI（阿那曲唑、来曲唑或依西美坦）。对于绝经前妇女，TAM 是绝经前和围绝经期妇女的推荐辅助激素治疗。这些患者亚组不建议使用 AI。最后，在选择最佳辅助激素治疗方案时，可以考虑 CYP2D6 多态性的测定。
