Endocrine therapy in the current management of postmenopausal Estrogen receptor-positive metastatic breast cancer

Virginia G. Kaklamani, William J. Gradishar

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Metastatic breast cancer (MBC) results in substantial morbidity and mortality for women afflicted with this disease. A majority of MBCs are hormone-responsive and estrogen receptorpositive, making endocrine therapy (ET) an integral component of systemic therapy. With a primary goal of minimizing the effects of estrogen on hormone-responsive MBC, ETs are among the first targeted treatments that aim to inhibit the influence of estrogen receptor activation on tumor proliferation. Several biochemical mechanisms have been the focus of drug development for treatment, including selective estrogen-receptor modulation, aromatase inhibition, and selective estrogen-receptor degradation. Treatments that exploit these mechanisms have improved survival and quality of life for women with MBC. However, in many cases, resistance to ET limits their effectiveness. Elucidation of the complex cellular signal cascades involved in the development of acquired resistance to ET and the interrelationship of growth factor signaling and estrogen responsiveness have characterized components of these pathways as attractive targets for drug development. Based on these insights and with the aim of overcoming hormone resistance, targeted therapies are emerging as useful treatments for MBC. This article reviews current endocrine treatments of MBC as well as recent and ongoing study of combination treatments and targeted therapies that interfere with cellular proliferation pathways as means of overcoming resistance.

Original languageEnglish (US)
Pages (from-to)507-517
Number of pages11
JournalOncologist
Volume22
Issue number5
DOIs
StatePublished - May 2017

Keywords

  • Aromatase inhibitors
  • Endocrine therapy
  • Estrogen receptor-positive
  • Metastatic breast cancer
  • Selective estrogen receptor modulators
  • Selective estrogen-receptor degrader

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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