Effects of steroidal and nonsteroidal aromatase inhibitors on markers of bone turnover in healthy postmenopausal women

Goss, Paul E.; Hadji, Peyman; Subar, Milayna; Abreu, Paula; Thomsen, T.; Banke-Bochita, J.

doi:10.1186/bcr1757

Cited by 83 publications

(55 citation statements)

References 35 publications

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“…They found that exemestane treatment induced many genes related to cell proliferation and genes encoding cytoskeleton proteins (29). Recently, Goss et al (30) reported that exemestane increased the serum level of procollagen I NH 2 -terminal propeptide, a marker of bone formation. From the results of a clinical trial on 128 women with early breast cancer, Lønning et al (31) concluded that exemestane modestly enhanced bone loss.…”

Section: Discussionmentioning

confidence: 99%

The Role of Amphiregulin in Exemestane-Resistant Breast Cancer Cells: Evidence of an Autocrine Loop

et al. 2008

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Section: Discussionmentioning

confidence: 99%

The Role of Amphiregulin in Exemestane-Resistant Breast Cancer Cells: Evidence of an Autocrine Loop

et al. 2008

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“…Those receiving AIs had a 27% increased risk of bone loss (p = 0.02) and a 21% increased risk of fracture (p = 0.02) [15]. Earlier findings with the steroidal AI exemestane had suggested some androgenic action (and potentially more bone-sparing effects) for this AI [16]. However, other studies suggest a similar impact on bone for the two classes of AIs.…”

Section: Adjuvant Endocrine Therapy and Bone Healthmentioning

confidence: 99%

Women and Bone Health: Maximizing the Benefits of Aromatase Inhibitor Therapy

Tang¹

2010

Oncology

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Postmenopausal women with early breast cancer (EBC) are already at risk for bone loss, osteoporosis and fracture as they age because of declining estrogen levels. Adjuvant hormonal therapy with aromatase inhibitors (AIs; e.g. letrozole, anastrozole, exemestane) can exacerbate this risk. All three AIs appear to have similar effects on bone, increasing bone turnover and fracture risk in postmenopausal women with EBC. Risk factors for bone loss can be used to assess fracture risk and the need for ongoing assessment and/or treatment in postmenopausal women receiving AIs for EBC. The concomitant, up-front use of intravenous bisphosphonate therapy, such as zoledronic acid, in combination with AIs can inhibit bone loss. In addition, a strong body of evidence suggests an anticancer activity of bisphosphonate therapy with zoledronic acid in EBC in both the pre- and postmenopausal adjuvant setting. Zoledronic acid thus provides a therapeutic option for postmenopausal women with EBC who may be at higher risk for bone loss while on AIs, allowing more patients to receive treatment with effective adjuvant hormonal therapy to prevent recurrence.

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“…(Sainsbury 2004). Conversely, a recent randomised comparison of thirdgeneration AI administered for 24 weeks in healthy women showed no significant difference in median percentual change from baseline for plasma concentrations of oestrone (E 1 ), oestradiol (E 2 ) and oestriol (E 3 ; Goss et al 2007).…”

Section: Biochemical Efficacymentioning

confidence: 95%

“…The effects of 24 months of treatment with exemestane, anastrozole or letrozole on the serum and urine levels of biomarkers of bone turnover were recently compared in 84 healthy postmenopausal women. Bone resorption markers like N-terminal telopeptide were increased to the greatest extent by letrozole, while exemestane was associated with increased serum levels of the bone formation marker like serum procollagen type I N-terminal propeptide, suggesting a specific bone formation effect related to its androgenic structure (Goss et al 2007). …”

Section: Side Effects: Osteoporosismentioning

confidence: 99%

Aromatase inhibitors for breast cancer: different structures, same effects?

Ponzone¹,

Mininanni²,

Cassina³

et al. 2008

Endocrine Related Cancer

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Aromatase inhibitors (AIs) have become the first-choice endocrine drugs for postmenopausal breast cancer patients since they are associated with superior activity and better general tolerability when compared with tamoxifen both in the adjuvant and metastatic settings. As a consequence, the question is no more if a postmenopausal patient should have AIs as part of her adjuvant treatment, but when should it be started or which one should be preferentially used. Newer compounds, generally defined as third-generation AIs, are biochemically more selective and potent when compared with older ones, and they also show superior clinical activity. As yet, no large randomised study has been published comparing the three third-generation AIs on the market. Nevertheless, both laboratory and clinical data suggest that the steroidal (exemestane) and non-steroidal (anastrozole, letrozole) AIs may have slightly different toxicity profiles, probably due to the low androgenic action of the formers. While waiting for randomised data on clinical efficacy of third-generation AIs, such differences may help select the best drug in elderly patients with a low cumulative risk of relapse and a significant amount of co-morbidities, such as cardiovascular disease or osteoporosis.

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Effects of steroidal and nonsteroidal aromatase inhibitors on markers of bone turnover in healthy postmenopausal women

Cited by 83 publications

References 35 publications

The Role of Amphiregulin in Exemestane-Resistant Breast Cancer Cells: Evidence of an Autocrine Loop

The Role of Amphiregulin in Exemestane-Resistant Breast Cancer Cells: Evidence of an Autocrine Loop

Women and Bone Health: Maximizing the Benefits of Aromatase Inhibitor Therapy

Aromatase inhibitors for breast cancer: different structures, same effects?

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