Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients

Eggemann, Holm; Ignatov, Atanas; Smith, Bobbie J.; Altmann, Udo; Minckwitz, Gϋnter von; Röhl, Freidrich W.; Jahn, M; Costa, Serban-Dan

doi:10.1007/s10549-012-2355-3

Cited by 143 publications

(82 citation statements)

References 28 publications

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“…These results add to current evidence in the female bc population [12][13][14] . The use of tamoxifen has been recommended in endocrine-sensitive male bc, with less evidence of efficacy for aromatase inhibitors (ais) 15 . The role of targeted therapies (for example, trastuzumab) in male bc has largely been unexplored.…”

Section: Discussionmentioning

confidence: 99%

“…The evidence to support the role of ais in male bc is sparse, being based mainly on retrospective case reports and case series. Recently, Eggemann et al 15 compared ais with tamoxifen in male bc and found that ais carried a mortality risk that was increased by a factor of 1.5 ( p = 0.007). Similar concerns have been noted in the female population.…”

Section: Discussionmentioning

confidence: 99%

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Treatment Outcomes for Male Breast Cancer: A Single-Centre Retrospective Case–Control Study

et al. 2014

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Background: Male breast cancer (bc) is a rare disease, and the availability of information on treatment outcomes is limited compared with that for female bc. The objective of the present study was to compare disease-free (dfs) and overall survival (os) for men compared with women having early-stage bc. Methods: This retrospective case–control study compared men and women treated for stage 0–iiib bc at a single institution between 1981 and 2009. Matching was based on age at diagnosis, year of diagnosis, and stage. Treatment, recurrence, and survival data were collected. Kaplan–Meier analysis was used to calculate os and dfs. Results: For the 144 eligible patients (72 men, 72 women), median age at diagnosis was 66.5 years. Treatments included mastectomy (72 men, 38 women), radiation (29 men, 44 women), chemotherapy (23 men, 20 women), and endocrine therapy (57 men, 57 women). Mean dfs was 127 months for women compared with 93 months for men (p = 0.62). Mean os was 117 months for women compared with 124 months for men (p = 0.35). In multivariate analysis, the only parameter that affected both dfs and os was stage at diagnosis. Conclusions: This case–control study is one of the largest to report treatment outcomes in early-stage male bc patients treated in a non-trial setting. Male patients received systemic therapy that was comparable to that received by their female counterparts, and they had similar os and dfs. These results add to current evidence from population studies that male sex is not a poor prognostic factor in early-stage breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes for Male Breast Cancer: A Single-Centre Retrospective Case–Control Study

et al. 2014

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“…Second, a wave of studies, though retrospective in nature, provided clues that ER-directed therapies are effective for treating MBC patients [8][9][10][11][12]. Antitumor efficacy has been reported with virtually all the antiestrogens currently available, namely tamoxifen, aromatase inhibitors (AIs) and fulvestrant [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Androgen receptor and antiandrogen therapy in male breast cancer

et al. 2015

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Cancers arising in the male breast are uncommon. Male breast cancer is a hormone-driven disease that often expresses the estrogen receptor, and antiestrogen therapy represents the mainstay of treatment. Paradoxically, the advent of a wave of antiestrogens eclipsed the therapeutic potential of alternative therapeutic options. At the beginning of the hormonal therapy era the administration of antiandrogens to metastatic male breast cancer patients was proposed. Ever since the use of these compounds has largely been neglected. A therapeutic role for antiandrogens has been envisioned again in recent years. First, molecular characterization efforts pointed to the androgen receptor as a potential therapeutic target. Second, the development of aromatase inhibitors unexpectedly raised the need for neutralizing androgens in order to tackle endocrine feedback mechanisms responsible for acquired resistance. We herein provide an overview of molecular studies where the androgen receptor was investigated at the genomic, transcriptomic or phenotypic level. We then discuss androgens in the context of the endocrine networks nourishing male breast cancer. Finally, clinical evidence on antiandrogens is summarized along with strategies should be implemented to improve the medical management of these patients.

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“…AIs, however, are suggested to have survival benefit compared with tamoxifen in female postmenopausal breast cancer patients with metastatic HR-positive breast cancer. In contrast, OS in men was significantly increased with tamoxifen compared with AIs (Eggemann et al 2013). This could be explained by the 'feedback loop' hypothesis.…”

Section: Aromatase Inhibition In Menmentioning

confidence: 83%

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

Asten¹,

Neven²,

Lintermans³

et al. 2014

Endocrine-Related Cancer

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Breast cancer is the most prevalent type of cancer in women and responsible for significant female cancer-related mortality worldwide. In the Western world, over 80% of breast cancers are hormone-receptor positive for which endocrine therapy is administered. The main anti-estrogen treatments in use consist of selective estrogen-receptor modulators, such as tamoxifen, and third-generation aromatase inhibitors (AIs), such as exemestane, letrozole, and anastrozole. In this review, the focus will lie on exemestane, its clinical use, and its side-effect profile. Exemestane is the only third-generation steroidal AI. Its efficacy as a first-line treatment in metastatic breast cancer has been demonstrated. Therefore, exemestane could be considered a valid first-line therapeutic option, but it also can be used in second-line or further situations. Exemestane is mostly used as part of sequential adjuvant treatment following tamoxifen, but in this setting it is also active in monotherapy. Furthermore, this AI has been studied in the neoadjuvant setting as presurgical treatment, and even as chemoprevention in high-risk healthy postmenopausal women. It may reverse side effects of tamoxifen, such as endometrial changes and thromboembolic disease but may also cause some inconvenient side effects itself. Additionally, there is a lack of total crossresistance between exemestane and nonsteroidal AIs as far as their anti-tumoral efficacy is concerned; moreover the two classes of AIs display a nontotal overlapping toxicity profile. Taking together, exemestane can be considered as a useful treatment option at all stages of breast cancer.

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Adjuvant therapy with tamoxifen compared to aromatase inhibitors for 257 male breast cancer patients

Cited by 143 publications

References 28 publications

Treatment Outcomes for Male Breast Cancer: A Single-Centre Retrospective Case–Control Study

Treatment Outcomes for Male Breast Cancer: A Single-Centre Retrospective Case–Control Study

Androgen receptor and antiandrogen therapy in male breast cancer

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

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