17. Cryosurgery for breast cancer: A challenge in current and future invasive oncology. Clinical experience since 1995

PURPOSE Based on the data and clinical experience derived from tamoxifen usage, the properties of an ideal antiestrogen is described that could have applications as a breast cancer preventative agent, long-term adjuvant therdpy, or as a treatment for osteoporosis. Each of the new antiestrogens currently being tested is discussed in terms of laboratory development, toxicology, pharmacology, endocrinology, and clinical evaluation. And each new compound is assessed according to the properties of an ideal antiestrogen. METHODS A review of all published reports was facilitated by the use of Medline computer searches. RESULTS Numerous compounds are being evaluated in clinical trials and can be categorized as triphenylethylenes or tamoxifen analogs, pure antiestrogens, and targeted antiestrogens. Several of these compounds may have fewer uterotropic properties and greater effects on maintaining bone density compared with tamoxifen; however, the clinical experience (ie, patient-years of treatment) with any of these compounds is minimal. CONCLUSION Although many of these compounds appear promising, further evaluation will be necessary to determine the role these compounds may serve as preventive agents, adjuvant therapies, treatments for advanced disease, or other medical indications such as osteoporosis.

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Clinical experience using fulvestrant in hormone responsive metastatic breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10749 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10749-10749

Author(s):

D. O. Bauerschlag ◽

C. Schem ◽

W. Jonat ◽

N. Maass

Keyword(s):

Breast Cancer ◽

Estrogen Receptor ◽

Postmenopausal Women ◽

Clinical Experience ◽

Aromatase Inhibitors ◽

Metastatic Breast ◽

Clinical Situation ◽

Endocrine Treatment ◽

Breast Cancer Patients ◽

Treatment Cascade

10749 Background: We report our clinical experience using the steroid estrogen receptor antagonist Fulvestrant to treat postmenopausal women with hormone sensitive metastasized breast cancer. We discuss the position of Fulvestrant in the endocrine treatment cascade, taking into account the new application guidelines for aromatase inhibitors. Methods: Data from 16 female patients and one male patient treated with Fulvestrant were analyzed. We describe the time point in the treatment cascade when Fulvestrant was administered and the resulting time to progression (TTP). The reviewed cohort was heterogeneous regarding the initial tumor size, the therapy and the progression of the tumor, respectively. The patients were 54 years of age at the time of diagnosis. The estrogen receptor was positive in all cases. Results: Fulvestrant was usually given as the last step in the endocrine treatment cascade (n = 14). The mean TTP was 5.7 months (n = 13). 3 patients are still under successful treatment with Fulvestrant. No common side effects as usually caused by endocrine therapies with Tamoxifen and aromatase inhibitors were documented. Conclusions: The specific estrogen receptor down-regulator Fulvestrant is a valid and well tolerated endocrine treatment option in heavily pre-treated and metastasized breast cancer patients (TTP 5.7 month). Also in the clinical situation of Tamoxifen resistant tumors, Patients could benefit from Fulvestrant. 3rd generation aromatase inhibitors are now used for the first-line treatment of breast cancer in postmenopausal women. Shifting the sequential endocrine therapy cascade might need a new positioning of Fulvestrant. No significant financial relationships to disclose.

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