Aromatase inhibitors in breast cancer

Describe the differences in study designs, clinical outcome, and safety data on aromatase inhibitors. Select the proper aromatase inhibitor based on a thorough understanding of the data that led to the specific indication for the drug. We examined published reports on the use of aromatase inhibitors in postmenopausal patients with hormone receptor-positive breast cancer. Current data indicate that aromatase inhibitors are equivalent or superior to tamoxifen as first-line therapy for metastatic breast cancer and as neoadjuvant treatment for primary breast cancer.
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Aromatase, Aromatase Inhibitors, and Breast Cancer

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Breast cancer treatment: Aromatase inhibitors | Breast Cancer Care

Estrogen and its metabolites play a significant role in the proliferation of hormone receptor-positive breast cancer. In postmenopausal women, aromatase inhibitors can significantly reduce estrogen levels by blocking enzyme-mediated estrogen synthesis within tissues. Third-generation aromatase inhibitors have now surpassed tamoxifen as first-line therapy for postmenopausal women with metastatic, hormone receptor-positive, breast cancer, showing improved response rates and time to progression. Aromatase inhibitors have shown incremental improvements in disease-free survival, lower local recurrence rates, lower metastatic recurrence rates, and a lower incidence of contralateral breast cancer over tamoxifen when used in the adjuvant setting. Aromatase inhibitors are recommended to be used as adjuvant therapy within the first 5 years of hormonal therapy and may be used either upfront for 5 years or sequenced with tamoxifen.
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Aromatase Inhibitors for Lowering Breast Cancer Risk

Estrogens are known to be important in the growth of breast cancers in both pre- and postmenopausal women. As the number of breast cancer patients increases with age, the majority of breast cancer patients are postmenopausal women. Although estrogens are no longer made in the ovaries after menopause, peripheral tissues produce sufficient concentrations to stimulate tumor growth. As aromatase catalyzes the final and rate-limiting step in the biosynthesis of estrogen, inhibitors of this enzyme are effective targeted therapy for breast cancer. Three aromatase inhibitors AIs are now FDA approved and have been shown to be more effective than the antiestrogen tamoxifen and are well tolerated.
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Aromatase inhibitors anastrozole, letrozole and exemestane are hormone therapy drugs used to treat hormone receptor-positive breast cancer. Aromatase inhibitors are only used to treat postmenopausal women and some premenopausal women also getting ovarian suppression. Some common side effects are described below. Joint pain arthralgia and muscle pain myalgia are common side effects of aromatase inhibitors [ ].
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