Is an aromatase inhibitor more effective than tamoxifen in neoadjuvant endocrine therapy for breast cancer?
Dimitrios H Roukos*, Michael Fatouros, Evangelos Paraskevaidis and Angelos M Kappas
Correspondence *Surgical Oncology Research Unit, Department of Surgery, Ioannina University School of Medicine, Ioannina GR-45110, Greece
Email droukos@cc.uoi.gr
This article has no abstract so we have provided the first paragraph of the full text.
The estrogen–estrogen receptor signaling pathway has a key role in breast-tumor formation, progression and metastasis. Endocrine therapies blocking this pathway were the first targeted therapies used for breast cancer.1 Tamoxifen has saved thousands of lives and is superior to chemotherapy for the distinct population of ER+ tumors; however, de novo and acquired resistance limit its treatment effect. Crosstalk between estrogen receptor and epidermal growth factor receptor/HER2 pathways might explain tamoxifen resistance. Aromatase inhibitors (AIs) dramatically lower estrogen levels and are more effective than tamoxifen in postmenopausal women. Indeed, a recent technology assessment, based on three positive randomized clinical trials studying anastrozole, exemestane and letrozole, suggested the inclusion of AIs in the postoperative adjuvant setting for postmenopausal women with ER+ tumors.2
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