scholarly journals Review: The Emerging Role of Metformin as Aromatase Inhibitor in Breast Cancer

2019 ◽  
Vol 4 (2) ◽  
pp. 1-10
Author(s):  
Amrilmaen Badawi
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Aromatase Inhibitor ◽  
Aromatase Inhibitors ◽  
Antidiabetic Agent ◽  
Menopausal Women ◽  
Work Mechanism ◽  
Post Menopausal ◽  
Very High

The prevalence of breast cancer is still very high among women, in particular post-menopausal women. There are many factors contributed to the diseases, including diabetes. Recently, it has been emerged that metformin, an antidiabetic agent, is capable of reducing the risk of developing breast cancer among post-menopausal women, and act as aromatase inhibitors (AIs) which inhibits the production of estrogen. In this review, we focus in discussing the possible work mechanism of metformin as AIs and what is in the pipeline on clinical trials.

Treatment of established breast cancer in post-menopausal women: Role of aromatase inhibitors

The Surgeon ◽  
2009 ◽  
Vol 7 (1) ◽  
pp. 42-55 ◽  
Author(s):  
S. Samphao ◽  
J.M. Eremin ◽  
M. El-Sheemy ◽  
O. Eremin
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Menopausal Women ◽  
Post Menopausal

scholarly journals Problems with the Use of Aromatase Inhibitors in Breast Cancer

2018 ◽  
Vol 4 (1) ◽  
pp. 41-42
Author(s):  
James J Stark
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitors ◽  
Hormone Receptor ◽  
Mineral Density ◽  
Dexa Scan ◽  
Hormone Receptor Positive ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Oncology Practice ◽  
Medicare Database

The use of Aromatase Inhibitors (AI’s) in the adjuvant therapy of operable breast cancer is ubiquitous. All guidelines in widespread use advocate their use in hormone-receptor-positive breast cancer in post-menopausal women. Premenopausal hormone-receptor-positive women who are considered at high risk of relapse are also treated with drug- or surgically-induced ovarian suppression plus an AI following chemotherapy, producing somewhat better results than those seen with chemo followed by tamoxifen [1]. A major side effect of these drugs is the accelerated loss of bone mineral density (BMD). The use of bone-sparing agents such as bisphosphonates has become widespread but not routine in these patients. Whether or not they receive bone-sparing agents, patients on AI’s should receive periodic assessment of bone density. How do doctors comply with this common-sense approach? The answer: not as often as they should. The best data on this practice was published in the Journal of Oncology Practice in May 2017 from a group of investigators at Yale [2]. Using the SEER Medicare database they identified over 135,000 women diagnosed with breast cancer from 2007 to 2010. Using robust exclusion criteria for such things as metastasis at presentation, too brief exposure to bisphosphonates, in situ only cancer, and prior diagnosis of osteoporosis, they identified 2409 women who met all entry criteria and served as the population studied. Within this group only 51% received a DEXA scan at initiation of AI and only 34% had a second scan within three years of being on therapy. What the authors were not able to ascertain was how many of these patients were placed on a prophylactic bisphosphonate or equivalent at the start of AI therapy. What was clear is that age and race had a lot to do with who received a DEXA scan. 30% of women over 85 vs. 56% ages 67-69 were scanned. 53% of causasian women were scanned vs. 33% non-caucasian. Wonen with higher stage and more comorbidities were also less likely to have been scanned.

Dementia risk among post-menopausal women treated with endocrine therapy for early-stage breast cancer in Ontario, Canada.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 521-521
Author(s):  
Phillip S. Blanchette ◽  
Melody Lam ◽  
Britney Le ◽  
Lucie Richard ◽  
Salimah Shariff ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Aromatase Inhibitor ◽  
Endocrine Therapy ◽  
Multivariable Analysis ◽  
Previous History ◽  
Income Quintile ◽  
P Value ◽  
Menopausal Women ◽  
Post Menopausal

521 Background: The association between anti-estrogen therapy and risk of dementia remains controversial. We performed a population-based real-world study investigating the association between endocrine therapy use and dementia. Methods: We used health administrative data collected from post-menopausal women (aged ≥66 years) who were diagnosed with breast cancer and started on adjuvant endocrine therapy from 2005-2012. Patients were classified by use of either an aromatase inhibitor or tamoxifen and followed to measure an unadjusted cumulative incidence of developing dementia. A multivariable analysis adjusting for age, income quintile, medical comorbidities, and duration of endocrine therapy was completed using a Cox-proportional hazards model. Results: We identified 12,077 patients of whom 73% were treated with an aromatase inhibitor and 27% with tamoxifen. The median age was 73 years (IQR 69-78), 64% of patients were treated with lumpectomy, and 19% received adjuvant chemotherapy. The unadjusted event rate for developing dementia was Hazard Ratio (HR)= 0.70 (95% confidence interval (CI)=0.63-0.78, p-value<0.0001) among patients receiving an aromatase inhibitor versus tamoxifen and the 5-year dementia incidence rate was 7.4% versus 9.2% respectively. Our multivariable analysis showed a significant decrease in the rate of dementia in patients treated with an aromatase inhibitor compared to tamoxifen (HR=0.88, 95% CI 0.78-0.98, p-value=0.02) with a median of 5.9 years of follow-up. Factors associated with the development of dementia included older age, previous history of ischemic heart disease, diabetes, hypertension and stroke. Duration of endocrine therapy and previous use of adjuvant chemotherapy were not associated with dementia in our study. Conclusions: This investigation indicates that use of aromatase inhibitors compared to tamoxifen is associated with a lower risk of developing dementia among post-menopausal breast cancer patients. Further prospective studies investigating the neurocognitive effects of endocrine therapy are warranted.

Tamoxifen and Endometrial Cancer

1996 ◽  
Vol 3 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Richard R. Barakat
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Large Scale ◽  
Early Stage ◽  
Tamoxifen Treatment ◽  
Breast Cancer Patients ◽  
Menopausal Women ◽  
Overall Survival Benefit ◽  
Post Menopausal

Tamoxifen is commonly used in the management of patients with breast cancer. Clinical trials of tamoxifen involving over 75,000 patients demonstrate an improved recurrence-free and overall survival benefit in both pre- and post-menopausal women. Large-scale trials also are evaluating the role of tamoxifen as a chemopreventive agent in women considered to be at high risk for developing breast cancer based on family history. Endometrial cancer is an uncommon complication of tamoxifen therapy. Since the majority of these cancers will be detected at an early stage when they are highly curable, however, the overall benefit of tamoxifen treatment in breast cancer patients outweighs this risk. All women receiving tamoxifen who have a uterus should undergo regular gynecologic examinations.

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