Prospects of neoadjuvant aromatase inhibitor therapy in breast cancer

Abstract

Over 40% of breast cancer patients are older than 70 years of age. In the last three decades, several clinical trials have attempted to determine the most effective and well-tolerated systemic treatments, especially for elderly women. Tamoxifen had been the standard adjuvant endocrine treatment for postmenopausal women with hormone-sensitive breast cancer, but recent trials have shown advantages in using third-generation aromatase inhibitors. Patients with large, operable or locally advanced breast cancer are often treated initially with neoadjuvant therapy to reduce their tumor size and allow for breast-conserving surgery. Neoadjuvant chemotherapy has been widely studied, but little has been published on neoadjuvant endocrine therapy. This article reviews the use of neoadjuvant aromatase inhibitors in postmenopausal women with hormone-sensitive breast cancer.

Keywords::

• anastrozole
• aromatase inhibitor
• breast cancer
• exemestane
• letrozole
• neoadjuvant therapy

Financial & competing interests disclosure

J Michael Dixon has received honoraria and unrestricted educational grants from Novartis, AstraZeneca and Pfizer who make letrozole, anastrozole and exemestane, respectively. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Assistance in developing an outline of this paper and referencing was provided by Phase Five Communications, Grey Healthcare Group, USA supported by Novartis. Following the preliminary outline, the manuscript was written by the author and represents solely the author’s views and opinions.