Non-neoplastic nuclear atypia in endometrial epithelium in postmenopausal women on hormonal therapy

Breast cancer is the most common cancer diagnosed and the second leading cause of cancer-related death in women. The majority of breast cancers diagnosed in postmenopausal women are hormone receptor positive and involve therapy with hormonal agents. Tamoxifen, a selective estrogen-receptor modulator, has been the mainstay of hormonal therapy since the 1970s. The more recent approval and success of aromatase inhibitors, such as anastrozole, letrozole, and exemestane, have seen these agents move to the front line of therapy for postmenopausal women with hormone-positive breast cancer in the adjuvant and metastatic settings. Fulvestrant, a selective estrogen receptor— downregulator, provides an additional hormonal therapy with a novel mechanism of action. This article reviews the current literature available regarding the use of these agents for postmenopausal women with early stage or advanced breast cancer.

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0244 A quality initiative: Guideline compliance in postmenopausal women with stage IB-IIIC early breast cancer receiving adjuvant hormonal therapy

The Breast ◽

10.1016/s0960-9776(09)70258-9 ◽

2009 ◽

Vol 18 ◽

pp. S79

Author(s):

L. Bosserman ◽

T. Vanderpool ◽

N. Bassi ◽

B. Emilio ◽

A. Borham ◽

...

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Early Breast Cancer ◽

Hormonal Therapy ◽

Adjuvant Hormonal Therapy ◽

Guideline Compliance ◽

Stage Ib

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Abstract S6-02: The efficacy and safety of the addition of ibandronate to adjuvant hormonal therapy in postmenopausal women with hormone-receptor positive early breast cancer. First results of the TEAM IIB trial (BOOG 2006-04)

10.1158/1538-7445.sabcs16-s6-02 ◽

2017 ◽

Cited By ~ 1

Author(s):

SB Vliek ◽

E Meershoek-Klein Kranenbarg ◽

AGJ van Rossum ◽

BC Tanis ◽

H Putter ◽

...

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Early Breast Cancer ◽

Hormonal Therapy ◽

Hormone Receptor ◽

Adjuvant Hormonal Therapy ◽

Efficacy And Safety ◽

Hormone Receptor Positive ◽

First Results

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Adjuvant Hormonal Therapy in Postmenopausal Women with Breast Cancer: Physician’s Choices

International Journal of Breast Cancer ◽

10.1155/2012/849592 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Asim Jamal Shaikh ◽

Shiyam Kumar ◽

Sajjad Raza ◽

Maria Mehboob ◽

Osama Ishtiaq

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Hormonal Therapy ◽

Tertiary Care ◽

Standard Of Care ◽

Care Hospital ◽

Adjuvant Hormonal Therapy ◽

Choice Data ◽

First Choice ◽

Clinical Survey

The choice of adjuvant hormonal therapy in postmenopausal women with hormone receptor positive breast cancer has remained a matter of controversy and debate. The variety of agents is available, with each claiming to be superior. This clinical survey was undertaken to get an impression of the physician’s first choice of therapy in an attempt to find out what questions still need to be answered in the making of “standard of care.” A web-based clinical survey was sent to the cancer physicians around the world, and 182 physicians responded to the survey. Most were medical oncologists in a tertiary care hospital. 36.3% preferred Anastrozole, 35.2% Tamoxifen, and 22.2% Letrozole as their first choice. Data support (67.8%) and safety concerns (30%) were given as the main reasons for the choice, 63.7% switched their therapy, and 24% had to switch because of side effects. 73.6% used 5 years of adjuvant hormonal therapy, 6.6% for 7 years, and 4.4% for 10 years. 61.5% follow their patients 3 times monthly, and 73.2% used laboratory and radiological assessment at each followup.Conclusion. Physicians show disagreement over the choice and duration of hormonal therapy in this patient population. Clinical trials leading to firm recommendations to set standards from which patients benefit the most are needed.

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The National Use of Hormonal Therapy in Postmenopausal Women in 2010

The Journal of Korean Society of Menopause ◽

10.6118/jksm.2011.17.3.150 ◽

2011 ◽

Vol 17 (3) ◽

pp. 150 ◽

Cited By ~ 5

Author(s):

Moon Kyoung Cho ◽

Hyoung Moo Park

Keyword(s):

Postmenopausal Women ◽

Hormonal Therapy

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Results of ENCORE 301, a randomized, phase II, double-blind, placebo-controlled study of exemestane with or without entinostat in postmenopausal women with locally recurrent or metastatic estrogen receptor-positive (ER+) breast cancer progressing on a nonsteroidal aromatase inhibitor (AI).

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.268 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 268-268 ◽

Cited By ~ 12

Author(s):

D. A. Yardley ◽

R. Ismail-Khan ◽

P. Klein

Keyword(s):

Breast Cancer ◽

Postmenopausal Women ◽

Hormonal Therapy ◽

Stage Iv ◽

Phase Iii ◽

Controlled Study ◽

Growth Factor Signaling ◽

Intrinsic Resistance ◽

Double Blind ◽

The Impact

268 Background: Hormonal therapy, including AIs, is the mainstay of ER+ breast cancer (BC) treatment; however, both acquired and intrinsic resistance limits its clinical benefit. Entinostat is a novel, oral, class I selective histone deacetylase inhibitor that has been shown to inhibit growth factor signaling pathways that mediate AI resistance. This study was designed to evaluate the impact of the addition of entinostat to exemestane therapy on progression-free survival (PFS). Methods: Postmenopausal women with ER+ advanced BC who had progressed on a non-steroidal AI were randomized to exemestane 25 mg daily + entinostat 5 mg or placebo weekly. Results: A total of 130 women were enrolled (66 exemestane+placebo; 64 exemestane+entinostat). All but 1 patient had Stage IV disease, and 82% had measurable disease. All patients had received prior hormonal therapy (1 prior line 42%; >1 prior line 58%), and 62% had received prior chemotherapy (33% in the advanced BC setting). Analysis of the intent-to-treat population showed that PFS was significantly (defined prospectively as p <0.10) longer with exemestane+entinostat than with exemestane+placebo (4.28 versus 2.27 months, respectively; hazard ratio [HR] = 0.73; p=0.06). Entinostat combined with exemestane was well-tolerated with the most frequent adverse events (AEs) consisting of fatigue, gastrointestinal disturbances, and hematologic abnormalities. AEs with a ≥20% higher incidence with exemestane+entinostat than with exemestane+placebo were fatigue (46% versus 26%, respectively) and uncomplicated neutropenia (25% versus 0%, respectively). The serious AE rate was similar for exemestane+entinostat (13%) and exemestane+placebo (12%). Conclusions: Exemestane+entinostat significantly prolonged the median PFS and reduced the risk of disease progression by 27% versus exemestane+placebo (HR = 0.73). In light of these positive data, a phase III evaluation of this combination is planned.

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