Management of endocrine resistant breast cancer

Sundar, Santhanam, Decatris, Marios P., & O'Byrne, Kenneth J. (2004) Management of endocrine resistant breast cancer. Journal of the British Menopause Society, 10(1), pp. 16-23.

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Abstract

Metastatic breast cancer (MBC) may present de novo but more commonly develops in women initially presenting with early breast cancer despite the widespread use of adjuvant hormonal and cytotoxic chemotherapy. MBC is incurable. Hormone sensitive MBC eventually becomes resistant to endocrine therapy in most women. Anthracyclines are the agents of choice in the treatment of endocrine resistant MBC. With the widespread use of anthracyclines in the adjuvant setting, taxanes have become the agents of choice for many patients. Recently capecitabine has become established as a standard of care for patients pretreated with anthracyclines and taxanes. However, a range of agents have activity as third line treatment. These include gemcitabine, vinorelbine and platinum analogues. The sequential use of non-cross resistant single agents rather than combination therapy is preferable in most women with MBC. Even though combination therapy can improve response rates and increase progression free interval, there is no robust evidence to indicate an advantage in terms of overall survival. Moreover, combination therapy is associated with a higher toxicity rate and poor quality of life. There is no role for dose-intense therapy, high dose therapy or maintenance chemotherapy outside the context of a clinical trial. The introduction of trastuzumab, monoclonal antibody targeting growth factor receptors, has improved the therapeutic options for women with tumours overexpressing HER2/neu. DNA micro-array profiles of tumours can potentially help to individualise therapy in future. Molecular targeted therapy has the potential to revolutionise the management of MBC.

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ID Code: 65716
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Biological therapy, Chemotherapy, Hormone therapy, Investigational therapies, Metastatic breast cancer, anthracycline derivative, aromatase inhibitor, capecitabine, carboplatin, cetuximab, cisplatin, cyclophosphamide, DNA, docetaxel, doxorubicin, epidermal growth factor receptor 2, epirubicin, erlotinib, estrogen receptor, fluorouracil, gefitinib, gemcitabine, growth factor receptor, methotrexate, mitomycin C, mitoxantrone, monoclonal antibody, navelbine, paclitaxel, platinum derivative, progesterone receptor, taxane derivative, trastuzumab, unindexed drug, vinblastine, antineoplastic activity, bone marrow transplantation, breast cancer, cancer adjuvant therapy, cancer chemotherapy, cancer combination chemotherapy, cancer radiotherapy, cancer surgery, cancer survival, cardiotoxicity, chill, clinical trial, diarrhea, DNA microarray, dose response, drug mechanism, drug megadose, drug response, drug targeting, fever, fluid retention, gene overexpression, hormonal therapy, hormone sensitivity, human, individualization, infection, metastasis potential, monotherapy, nausea, neuropathy, prognosis, protein targeting, quality of life, review, side effect, skin manifestation, stomatitis, vomiting, Anthracyclines, Antineoplastic Agents, Breast Neoplasms, Drug Resistance, Neoplasm, Female, Humans, Neoplasm Metastasis
DOI: 10.1258/136218004322986735
ISSN: 1362-1807
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2004 British Menopause Society
Deposited On: 07 Jan 2014 06:28
Last Modified: 21 Apr 2015 00:40

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