Treatment strategy for metastatic breast cancer with estrogen receptor-positive tumor
- 612 Downloads
Metastatic breast cancer (MBC) is not a curable disease except for local recurrence or oligo-metastasis in the non-visceral organs. In fact, the 10-year survival rate after chemotherapy is approximately 5 %, and, for patients who survive, the complete response rate beyond 20 years is only 2–3 % [1, 2]. Consequently, the purpose of treatment is the prolongation of survival and the improvement of quality of life (QOL). By means of advances in treatment with the advent of a large number of new drugs, survival after recurrence has been gradually improved since the 1990s [3, 4].
Although cytotoxic chemotherapy induces severe adverse events, such as anorexia, nausea and vomiting, neurotoxicity, and hematological disorders, no clear data are available concerning the overall survival benefit compared to endocrine therapy for cases of MBC with estrogen receptor-positive (ER+) tumors [5, 6]. Endocrine therapy in breast cancer represents one of the earliest molecular-targeting...
KeywordsEndocrine Therapy Human Epidermal Growth Factor Receptor Metastatic Breast Cancer Letrozole Exemestane
Conflict of interest
The author and his immediate family members declare their conflicts of interest as follows: employment, not applicable (N/A); leadership, N/A; consultant, N/A; stock, N/A; honoraria, AstraZeneca; research funds, Chugai-Roche, AstraZeneca, Novartis, Takeda, Taiho; testimony, N/A; other, N/A.
- 13.Howell A, Robertson JF, Abram P et al (2004) Comparison of fulvestrant versus tamoxifen for the treatment of advanced breast cancer in postmenopausal women previously untreated with endocrine therapy: a multinational, double-blind, randomized trial (translated from Eng). J Clin Oncol 22(9):1605–1613 (in Eng)CrossRefPubMedGoogle Scholar
- 14.Di Leo A, Jerusalem G, Petruzelka L et al (2010) Results of the CONFIRM phase III trial comparing fulvestrant 250 mg with fulvestrant 500 mg in postmenopausal women with estrogen receptor-positive advanced breast cancer (translated from Eng). J Clin Oncol 28(30):4594–4600 (in Eng)CrossRefPubMedGoogle Scholar
- 15.Byrne MJ, Gebski V, Forbes J et al (1997) Medroxyprogesterone acetate addition or substitution for tamoxifen in advanced tamoxifen-resistant breast cancer: a phase III randomized trial. Australian–New Zealand Breast Cancer Trials Group (translated from Eng). J Clin Oncol 15(9):3141–3148 (in Eng)PubMedGoogle Scholar
- 18.Iwase H, Yamamoto Y, Yamamoto-Ibusuki M et al (2013) Ethinylestradiol is beneficial for postmenopausal patients with heavily pre-treated metastatic breast cancer after prior aromatase inhibitor treatment: a prospective study (translated from Eng). Br J Cancer 109(6):1537–1542 (in Eng)CrossRefPubMedCentralPubMedGoogle Scholar
- 21.Burzykowski T, Buyse M, Piccart-Gebhart MJ et al (2008) Evaluation of tumor response, disease control, progression-free survival, and time to progression as potential surrogate end points in metastatic breast cancer (translated from Eng). J Clin Oncol 26(12):1987–1992 (in Eng)CrossRefPubMedGoogle Scholar