Purpose: Antiestrogens are used to treat estrogen receptor (ER)-α-positive breast cancers and cause a p27-dependent G 1 arrest. Estrogen-bound ER recruits Src to mediate proteolysis of p27 and drive cell proliferation. Here, we tested the antitumor efficacy of combined Src and aromatase inhibition for ER-positive breast cancer. Experimental Design: Antiproliferative effects of the aromatase inhibitor, anastrozole, and Src inhibitor, AZD0530, alone or in combination were tested in vitro and in vivo on aromatase-transfected MCF-7Arom5 xenografts. Xenografts were analyzed by immunohistochemistry and proteomic analysis to identify potential biomarkers of drug response and resistance. Results: AZD0530 and anastrozole together increased p27 and caused greater G 1 cell cycle arrest than either drug alone. AZD0530 monotherapy initially retarded xenograft growth in vivo, but drug resistance rapidly emerged. Combined anastrozole/AZD0530 reduced drug resistance and showed greater antitumor efficacy in vivo with greater Src and epidermal growth factor receptor inhibition and a greater increase in p27 and reduction of Ki-67 than either drug alone, supporting further evaluation of these putative predictors of response to combined Src/aromatase inhibition in vivo. Anastrozole alone stimulated Src activity both in vitro and in vivo. AZD0530-resistant tumors showed activation of bypass pathways including MEK and phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin, raising the possibility that MEK, mammalian target of rapamycin (mTOR), or PI3K inhibitors may augment Src inhibitor efficacy. Conclusions: These data support clinical investigation of anastrozole-AZD0530 therapy for postmenopausal ER-positive breast cancer. Loss of p27 and increased Ki-67 may predict response and further clinical studies should evaluate for activation of bypass pathways including MEK and PI3K pathways during Src inhibitor therapy.Estrogen is a potent mitogen and a survival factor for many estrogen receptor (ER)-α-positive human breast cancer lines and appears to play a role in the genesis and progression of a majority of breast cancers. ER blockade and drug-mediated estrogen deprivation are used in ER-positive breast cancer both as adjuvant treatments to prevent recurrence after initial breast surgery and for metastatic disease (1). Aromatase inhibitors such as anastrozole and letrozole have significantly improved the efficacy of endocrine therapy (2). Adrenal androstenedione and testosterone undergo peripheral conversion to estrogen by aromatase. Aromatase inhibitors block the last biosynthetic step in estrogen production (2) and cause >90% reduction in circulating estrogens in postmenopausal women (1). Anastrozole was the first aromatase inhibitor tested in large clinical trials in both metastatic and adjuvant settings and showed superior antitumor activity compared with tamoxifen (1, 2).Oncogenic activation of the Src tyrosine kinase regulates proliferation, motility, and survival in many human cancers (3). We observed t...