By John F.R. Robertson, Robert I. Nicholson, Daniel F. Hayes
This article studies the newest principles in tumor biology, explains the pharmacologic foundation of the brokers used, and discusses how they're utilized in scientific perform. half One offers an summary of the medical significance of endocrine treatment, and describes the purposes of the crucial sessions of substances, together with antiestrogens, aromatase inhibitors, progestins, and progesterone receptor antagonists. This part additionally discusses ovarian ablation. half bargains with the organic points of endocrine treatments, and relates present realizing of tumor biology and the pharmacologic foundation of hormonal brokers to their scientific purposes. one of the issues coated are resistance and sensitivity to treatment. half 3 outlines destiny concepts, specifically using blend endocrine remedy, adjuvant development issue remedy and using anti-invasive brokers. this article is vital for oncologists and pharmacologists alike.
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Additional info for Endocrine Therapy of Breast Cancer
21 Two North American trials comparing tamoxifen treatment for 5 or 10 years,12,14 and a Scottish trial comparing tamoxifen for 5 years with indefinite treatment13 have been published, showing no additional benefit with prolonged therapy. 14 This data is tentative and based on a post hoc analysis of a small number of patients. Thus, overall, there is no convincing data that treatment lasting longer than 5 years was beneficial. 12 On the basis of these results, it is now reasonable to recommend that tamoxifen be given for 5 years.
Eur J Cancer 1993; 29A: 1498. West CP, Baird DT. Suppression of ovarian activity by Zoladex depot (ICI 118 630), a long acting luteinizing hormone releasing hormone agonist analogue. Clin Endocrinol 1987; 26: 213–20. Gallen M, Alonso MC, Ojeda B et al. Randomized multicentre trial comparing two different timespans of adjuvant tamoxifen therapy (ATT) in women with operable node positive breast cancer. Proc Am Soc Clin Oncol 1994; 13: 76. Swedish Breast Cancer Cooperative Group. Randomized trial of 2 versus 5 years of adjuvant tamoxifen in postmenopausal early-stage breast cancer.
4). The results of many of these studies became available for the 2000 Oxford Overview and will shed considerable further light on this situation when they are published in their final form, which is likely to be in 2002 or 2003. These larger and therefore more highly powered studies of 25 medical ovarian ablation will add considerably to what is already known about the role of surgical and irradiation ablation in the adjuvant therapy of premenopausal women. Relationship between amenorrhoea and response to chemotherapy The results outlined above suggest that ovarian ablation may not be as effective when it is added to chemotherapy as it is when given alone.
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