ABSTRACT
New aromatase inhibitors are an exciting treatment option for postmenopausal women with hormone sensitive breast cancer. They have been shown to reduce tumors in a significant number of patients, and exhibit definite antitumor activity at a relatively low daily dose, and are highly potent, highly selective, and well-tolerated. Results from recent clinical phase III studies have confirmed their efficacy and the key role they have in the therapy for advanced breast cancer in postmenopausal women. The agents available for clinical use are: letrozole, anastrozole, and exemestane. These drugs have demonstrated high activity in women failing tamoxifen in locally advanced or metastatic disease. This communication reviews the clinical use of aromatase inhibitors, particularly in second and first line hormonal treatment of advanced breast cancer.
Subject(s)
Androstadienes/therapeutic use , Antineoplastic Agents/therapeutic use , Aromatase Inhibitors , Breast Neoplasms/drug therapy , Enzyme Inhibitors/therapeutic use , Estrogens , Neoplasm Proteins/antagonists & inhibitors , Neoplasms, Hormone-Dependent/drug therapy , Nitriles/therapeutic use , Triazoles/therapeutic use , Anastrozole , Androstadienes/pharmacology , Antineoplastic Agents/pharmacology , Antineoplastic Agents, Hormonal/pharmacology , Antineoplastic Agents, Hormonal/therapeutic use , Breast Neoplasms/enzymology , Breast Neoplasms/pathology , Clinical Trials, Phase I as Topic , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Double-Blind Method , Enzyme Inhibitors/pharmacology , Female , Humans , Letrozole , Multicenter Studies as Topic , Neoplasms, Hormone-Dependent/pathology , Nitriles/pharmacology , Postmenopause , Randomized Controlled Trials as Topic , Triazoles/pharmacologyABSTRACT
We verified the variations of primary tumour steroid receptor status and proliferative activity at different times and phases (follicular vs luteal) of the menstrual cycle and their relationship with short clinical outcome in a cohort of 248 N- breast cancer patients. Steroid receptor content (ER and PgR) was evaluated by DCC assay and proliferative activity by 3H-Thymidine autoradiographic assay (TLI). Median age was 44 years, 60% of tumors were T1, and cytohistological grade was G1-2 in 54% of cases. At surgery, 57% were in the luteal phase while 43% were in the follicular phase. No significant variations were found in mean TLI or ER and PgR characteristics of the primary tumors surgically treated in different periods of the menstrual cycle; however, the ER level resulted significantly higher in 4th with respect to the 3rd week of menstrual cycle, while PgR level was higher in PgR+ cases treated during the 3rd week. The number of relapses and disease-free survival curves after 36 months median follow-up did not differ significantly for patients treated in different periods of the menstrual cycle (12% and 9% of disease relapses in luteal and follicular phases; p=n.s.). We can conclude, therefore, that TLI, ER and PgR expressions could vary significantly during menstrual cycle only in certain specific tumor subgroups.
Subject(s)
Breast Neoplasms/physiopathology , Breast Neoplasms/surgery , Menstrual Cycle , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Adult , Age Factors , Analysis of Variance , Breast Neoplasms/pathology , Cytoplasm/chemistry , Disease-Free Survival , Female , Humans , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local , Neoplasm Staging , Prognosis , Recurrence , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
The authors report three cases of ovarian fibroma in women in advanced menopause (mean age: 70 years). The neoplasm was bilateral in one patient. Early symptoms were pelvic pain, and, in one patient, menorrhagia without histologic alterations of the atrophic endometrium. The histology was typical of ovarian fibromas, except for one case which was characterized by a dense pseudofibrosarcomatous pattern and by the presence of numerous sex cord elements.
