Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, United States.
Maturitas. 2011 Dec;70(4):315-21. doi: 10.1016/j.maturitas.2011.09.006. Epub 2011 Oct 5.
Tamoxifen had been the only available hormonal option for the systemic treatment for breast cancer from 1973 to 2000. Enormous efforts have led to the development of potent and selective third generation aromatase inhibitors including anastrozole, letrozole and exemestane. Due to their superior efficacy to tamoxifen, aromatase inhibitors are presently approved as first line agents for the treatment of advanced estrogen receptor (ER) positive breast cancer and adjuvant therapy in early ER positive early breast cancer in postmenopausal women. Selective ER Modulators (SERMS), tamoxifen and raloxifene are the only agents presently used in breast cancer prevention in high risk women and their use has increased substantially over the last decade. Third generations SERMS, lasofoxifene and bazedoxifene have shown significant reduction in bone loss compared to placebo in postmenopausal women and are currently approved in the European Union for the treatment of postmenopausal osteoporosis. This review outlines the current strategies employed in the use of endocrine therapy in the management and prevention of breast cancer.
他莫昔芬是 1973 年至 2000 年间唯一可用于治疗乳腺癌的激素药物。经过巨大的努力，人们开发出了第三代强效且选择性的芳香化酶抑制剂，包括阿那曲唑、来曲唑和依西美坦。由于其疗效优于他莫昔芬，芳香化酶抑制剂目前被批准用于治疗晚期雌激素受体（ER）阳性乳腺癌和绝经后妇女早期 ER 阳性乳腺癌的辅助治疗。选择性雌激素受体调节剂（SERMS）、他莫昔芬和雷洛昔芬是目前用于高危女性乳腺癌预防的唯一药物，在过去十年中其使用量大幅增加。第三代 SERMS，拉索昔芬和巴多昔芬与安慰剂相比，在绝经后妇女中显著减少了骨质流失，目前在欧盟被批准用于治疗绝经后骨质疏松症。这篇综述概述了目前在乳腺癌的管理和预防中使用内分泌治疗的策略。
