Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer

Stefano Gonnelli1, Roberto Petrioli21Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Italy (Dir. R. Nuti.); 2Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy (Dir. G. Francini)Abstract: The third-gene...

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Autores principales:	Stefano Gonnelli, Roberto Petrioli
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Breast cancer Aromatase inhibitors Bone loss Lipids Cardiovascular risk Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/0a64a60dcabf4cc6a248eee57f1efdcd
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spelling	oai:doaj.org-article:0a64a60dcabf4cc6a248eee57f1efdcd2021-12-02T00:40:47ZAromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer1178-1998https://doaj.org/article/0a64a60dcabf4cc6a248eee57f1efdcd2008-12-01T00:00:00Zhttps://www.dovepress.com/aromatase-inhibitors-efficacy-and-metabolic-risk-in-the-treatment-of-p-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Stefano Gonnelli1, Roberto Petrioli21Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Italy (Dir. R. Nuti.); 2Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy (Dir. G. Francini)Abstract: The third-generation aromatase inhibitors (AIs), letrozole, anastrozole and exemestane, are becoming the first choice endocrine drugs for post-menopausal women with breast cancer, since they present greater efficacy when compared with tamoxifen in both adjuvant and metastatic setting. In particular, several large and well designed trials have suggested an important role for AIs in the adjuvant treatment of postmenopausal women with estrogen-receptor positive breast cancer either in the upfront, sequential or extended adjuvant mode. Overall, AIs are associated with a small but significant improvement in disease free survival. The expanding use of AIs in the treatment of early breast cancer means that individual patients will be exposed to the agents for longer durations, making it increasingly important to establish their long-term safety. This review focused on the effects of AIs on bone metabolism, serum lipids and cardiovascular risk. AIs have adverse effects on bone turnover with a reduction of bone mineral density and an increase in the rate of fragility fractures. With respect to tamoxifen AIs present lower thrombotic risk and a less favorable impact on lipid profile, whereas the true effects on cardiovascular risk still remain to be clarified. An adequate monitoring of bone mineral density (BMD) and lipid profile could be recommended for post-menopausal women candidate to AIs.Keywords: breast cancer, aromatase inhibitors, bone loss, lipids, cardiovascular riskStefano GonnelliRoberto PetrioliDove Medical PressarticleBreast cancerAromatase inhibitorsBone lossLipidsCardiovascular riskGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 3, Pp 647-657 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Breast cancer Aromatase inhibitors Bone loss Lipids Cardiovascular risk Geriatrics RC952-954.6
spellingShingle	Breast cancer Aromatase inhibitors Bone loss Lipids Cardiovascular risk Geriatrics RC952-954.6 Stefano Gonnelli Roberto Petrioli Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
description	Stefano Gonnelli1, Roberto Petrioli21Department of Internal Medicine, Endocrine-Metabolic Science and Biochemistry, University of Siena, Italy (Dir. R. Nuti.); 2Department of Human Pathology and Oncology, Medical Oncology Section, University of Siena, Italy (Dir. G. Francini)Abstract: The third-generation aromatase inhibitors (AIs), letrozole, anastrozole and exemestane, are becoming the first choice endocrine drugs for post-menopausal women with breast cancer, since they present greater efficacy when compared with tamoxifen in both adjuvant and metastatic setting. In particular, several large and well designed trials have suggested an important role for AIs in the adjuvant treatment of postmenopausal women with estrogen-receptor positive breast cancer either in the upfront, sequential or extended adjuvant mode. Overall, AIs are associated with a small but significant improvement in disease free survival. The expanding use of AIs in the treatment of early breast cancer means that individual patients will be exposed to the agents for longer durations, making it increasingly important to establish their long-term safety. This review focused on the effects of AIs on bone metabolism, serum lipids and cardiovascular risk. AIs have adverse effects on bone turnover with a reduction of bone mineral density and an increase in the rate of fragility fractures. With respect to tamoxifen AIs present lower thrombotic risk and a less favorable impact on lipid profile, whereas the true effects on cardiovascular risk still remain to be clarified. An adequate monitoring of bone mineral density (BMD) and lipid profile could be recommended for post-menopausal women candidate to AIs.Keywords: breast cancer, aromatase inhibitors, bone loss, lipids, cardiovascular risk
format	article
author	Stefano Gonnelli Roberto Petrioli
author_facet	Stefano Gonnelli Roberto Petrioli
author_sort	Stefano Gonnelli
title	Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
title_short	Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
title_full	Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
title_fullStr	Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
title_full_unstemmed	Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
title_sort	aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/0a64a60dcabf4cc6a248eee57f1efdcd
work_keys_str_mv	AT stefanogonnelli aromataseinhibitorsefficacyandmetabolicriskinthetreatmentofpostmenopausalwomenwithearlybreastcancer AT robertopetrioli aromataseinhibitorsefficacyandmetabolicriskinthetreatmentofpostmenopausalwomenwithearlybreastcancer
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Aromatase inhibitors, efficacy and metabolic risk in the treatment of postmenopausal women with early breast cancer

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