Endocrine therapy for advanced breast cancer: A review

Abstract

More than 45,000 women will die of metastatic breast cancer in the United States in 1991. Endocrine therapy remains a major option for treatment of such patients, and results in complete plus partial response rates of 30% with a median duration of approximately one year. Postmenopausal status, increased age, a prolonged disease-free interval, bone and soft tissue metastases, and positive estrogen and progesterone receptors are all associated with an increased response to endocrine therapy. The use of additive hormonal therapy, specifically antiestrogens, progestins, and aromatase inhibitors, have replaced surgical ablative procedures in the majority of patients; response rates to antiestrogen therapy, progestin therapy, and aromatase inhibitors are similar, but antiestrogens have generally been associated with the most favorable therapeutic index. At present, there is no convincing evidence that either combinations of endocrine therapies or endocrine therapy combined with chemotherapy are associated with an improvement in survival for patients with metastatic disease. Future research efforts directed at defining the molecular mechanisms of endocrine activity should facilitate clinical trials of newer and potentially more effective agents. All patients with metastatic breast cancer should be considered for at least one trial of endocrine therapy provided their metastatic disease is not rapidly progressive or life-threatening.

A Role of Androgen Receptor Protein in Cell Growth of an Androgen-Independent Prostate Cancer Cell Line

“…Such breast cancer patients often become recurrent. 22) But a pure ER antagonist, fulvestrant, has recently been found to show the growth inhibitory effect on tamoxifen-resistant breast cancer in a clinical study. 23) Since fulvestrant is known to induce ER protein degradation by binding to ER, 24) suppression of AR protein expression by an AR ligand is assumed to be effective against prostate cancer, which is resistant to androgen-deprivation therapy.…”

N-Alkoxy derivatization of indole-3-carbinol increases the efficacy of the G1 cell cycle arrest and of I3C-specific regulation of cell cycle gene transcription and activity in human breast cancer cells

“…Approximately one-third of all breast cancers are estrogen responsive, and endocrine therapy targeting the estrogen receptor directly, such as with the nonsteroidal anti-estrogen tamoxifen, or indirectly, such as with aromatase inhibitors, are the main adjuvant therapies used to control the growth of estrogen responsive breast cancers [1][2][3][4]. Current options for treatment of most other breast cancers include surgical removal of tumors, general chemotherapy and/or radiation therapy.…”

AP-1, but not NF-κB, is required for efficient steroid-triggered cell death in Drosophila

“…21,22 For example, glucocorticoids regulate cell death in the central nervous system, sex steroids control cell death in the ovary, and progesterone can inhibit cell death in breast cancer cells. 23 ± 25 Steroid hormones have also been used for treatment of prostate and breast cancers 26,27 and extensive efforts are underway to alter apoptotic signaling pathways in order to control other diseases, including viral infections, autoimmune diseases, and neurodegenerative disorders. 28 ± 30 We are studying the fruit fly, Drosophila melanogaster, as a model system for defining the hormonal regulation of programmed cell death.…”