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Hormonal Therapy in Cancer

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Cancer Management in Man: Chemotherapy, Biological Therapy, Hyperthermia and Supporting Measures

Part of the book series: Cancer Growth and Progression ((CAGP,volume 13))

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Abstract

Endocrine manipulation in cancer therapy, beginning with oophorectomy as an early treatment for breast cancer, has shown beneficial results since its introduction into clinical practice over a century ago (Beatson, Lancet 2:104–107, 1896). Recognition of the role of the estrogen receptor (ER) in cancer biology 40 years ago (Jensen et al., Arch Anat Microsc Morphol Exp 56(3):547–569, 1967) and the subsequent development of targeted hormonal therapies such as ER antagonists and selective estrogen receptor modulators (SERMs) has been the cornerstone of therapy for hormone-sensitive breast cancer for many years. While tamoxifen has been the agent of choice for several decades, the aromatase inhibitors (AIs), acting by a different mechanism to modulate ER signaling, are now an integral part of anti-hormonal therapy in postmenopausal women with either early stage or late stage breast cancer. Selective estrogen down-regulators (SERDs), such as fulvestrant, have emerged as an alternative therapeutic option for women with advanced disease. The additional benefits of ovarian function suppression (OFS) in addition to tamoxifen or in combination with AI, in premenopausal women, are currently under investigation. For hormone-sensitive advanced prostate cancer, androgen-deprivation therapy (ADT), either through medical or surgical castration, has been the mainstay of hormonal manipulation since the 1940s (Jensen et al., Arch Anat Microsc Morphol Exp 56(3):547–569, 1967). Luteinizing hormone-releasing hormone (LHRH) agonists are widely utilized and very effective forms of medical castration. Whether the addition of anti-androgens to medical or surgical castration provides an additional benefit for some or all men with advanced prostate cancer, has been the subject of many randomized trials and meta-analyses and remains a topic of debate. Secondary hormonal manipulation with agents such as ketoconazole, which blocks testicular and adrenal gland steroid synthesis, has been used to delay the need for systemic chemotherapy. Hormonal therapy plays a role in the treatment of a number of other cancer types, but is more commonly used as palliative or second-line treatment.

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  1. Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center, Experimental Therapeutics and Breast Medical Oncology, 12902 Magnolia Dr, Tampa, FL, 33612, USA

    Soe T. Maunglay, Julia A. Cogburn & Pamela N. Munster

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  1. Moores UCSD Cancer Center, 3855 Health Sciences Drive 0820, La Jolla, 92093-0820, California, USA

    Boris R. Minev

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Maunglay, S.T., Cogburn, J.A., Munster, P.N. (2011). Hormonal Therapy in Cancer. In: Minev, B. (eds) Cancer Management in Man: Chemotherapy, Biological Therapy, Hyperthermia and Supporting Measures. Cancer Growth and Progression, vol 13. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-9704-0_9

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