Kudoh M
Endocrinology & Metabolic Disease Research Laboratory, Institute for Drug Discovery Research, Yamanouchi Pharmaceutical Co., Ltd. Tsukuba, Japan.
Gan To Kagaku Ryoho. 1996 May;23(6):668-72.
It is established that estrogen and androgen facilitate the proliferation of breast and prostate cancers. Hormonal therapy for these tumors using agents which inhibit hormone synthesis (inhibitors of aromatase and lyase) or bind hormone receptor have been used. However, some patients become resistant gradually during the hormonal therapy. Furthermore, QOL of patients was impaired by the side effects associated with the therapy, such as decreases in bone density, libido, and potency. The osteoporosis is a potential concern with the prolonged use of antiestrogen. The beneficial effect of estrogen receptor antagonist, tamoxifen on breast cancer has been established, but this agent may increase the proliferation of endometrium, which may increase the incidence of uterine cancer. Tamoxifen is a partial agonist, leading to the increase in transcriptional activity. Recently, ICI-164.384 is reported to be a pure antagonist and effective in tamoxifen-refractory tumor. Hopefully, pure antiandrogen will be available in the near future. There are reports suggesting that several specific and tissue-specific factors are involved in transcriptional activity of sex steroid hormone receptors. It is likely that these factors are novel targets for drugs which have a high potency and organ-or tissue-selective antagonist of sex steroid hormone for the treatment of hormone-dependent cancers.
已证实雌激素和雄激素会促进乳腺癌和前列腺癌的增殖。已使用抑制激素合成的药物(芳香化酶和裂解酶抑制剂)或结合激素受体的药物对这些肿瘤进行激素治疗。然而,一些患者在激素治疗过程中会逐渐产生耐药性。此外,与治疗相关的副作用,如骨密度降低、性欲减退和性功能减退,会损害患者的生活质量。长期使用抗雌激素药物会引发骨质疏松这一潜在问题。雌激素受体拮抗剂他莫昔芬对乳腺癌的有益作用已得到证实,但该药物可能会增加子宫内膜的增殖,从而可能增加子宫癌的发病率。他莫昔芬是一种部分激动剂,会导致转录活性增加。最近,有报道称ICI - 164.384是一种纯拮抗剂,对他莫昔芬难治性肿瘤有效。有望在不久的将来获得纯抗雄激素药物。有报道表明,几种特定的组织特异性因子参与了性类固醇激素受体的转录活性。这些因子很可能是新型药物靶点,这些药物对性类固醇激素具有高效能且器官或组织选择性的拮抗剂,用于治疗激素依赖性癌症。