Can biomarkers direct the optimal use of aromatase inhibitors versus selective estrogen receptor modulators?
Rachel Schiff* and Adrian V Lee
Correspondence *Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
Email rschiff@breastcenter.tmc.edu
This article has no abstract so we have provided the first paragraph of the full text.
Understanding and predicting endocrine resistance is an important task in breast cancer management. Third-generation AIs have shown superiority to tamoxifen in the treatment of postmenopausal patients with early and advanced ER+ breast cancer and are thus becoming the first choice for endocrine therapy. It is not clear whether AIs are superior in all ER+ tumors, however, or whether a subgroup of these tumors might be selectively responsive to AIs but resistant to tamoxifen. Tovey et al. have recently demonstrated that HER1–3 overexpression and PR negativity are key biomarkers that alone, or in combination, predict de novo resistance to tamoxifen. Importantly, these tumor biomarkers might also distinguish tumors that have selective resistance to tamoxifen, but no resistance to AI therapy. Novel insights into ER signaling and the biology of ER+/PR- tumors might help to explain the interaction between hyperactive growth factor receptor signaling, PR negativity, and tamoxifen resistance.
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