Anastrozole, an aromatase inhibitor, and medroxyprogesterone acetate therapy in premenopausal obese women with endometrial cancer: a report of two cases successfully treated without hysterectomy

Burnett, Alexander; Bahador, Afshin; Amezcua, Charles A.

doi:10.1016/j.ygyno.2004.06.004

Cited by 41 publications

(31 citation statements)

References 8 publications

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“…3A). Although efficacy is variable based on a few case studies (Rose et al 2000, Berstein et al 2002, Burnett et al 2004, Leunen et al 2004, AIs do show promise as an alternative endocrine therapy for EC especially who has high sensitivity to AI. Our system suggests that AIs may be effective in a subset of carefully screened patients with estrogendependent EC.…”

Section: Discussionmentioning

confidence: 99%

Estrogen signaling ability in human endometrial cancer through the cancer-stromal interaction

Matsumoto

Yamaguchi

Seino

et al. 2008

Endocrine Related Cancer

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The estrogen pathway plays an important role in the etiology of human endometrial carcinoma (EC). We examined whether estrogen biosynthesis in the tumor microenvironment promotes endometrial cancer. To examine the contribution of stromal cells to estrogen signaling in EC, we used reporter cells stably transfected with the estrogen response element (ERE) fused to the destabilized green fluorescent protein (GFP) gene. In this system, the endometrial cancer stromal cells from several patients activated the ERE of cancer cells to a variable extent. The GFP expression level increased when testosterone, a substrate for aromatase, was added. The effect was variably inhibited by aromatase inhibitors (AIs), although the response to AIs varied among patients. These results suggest that GFP expression is driven by estrogen synthesized by aromatase in the endometrial cancer stromal cells. In a second experiment, we constructed an adenovirus reporter vector containing the same construct as the reporter cells described above, and visualized endogenous ERE activity in primary culture cancer cells from 15 EC specimens. The GFP expression levels varied among the cases, and in most primary tissues, ERE activities were strongly inhibited by a pure anti-estrogen, fulvestrant. Interestingly, a minority of primary tissues in endometrial cancer showed ERE activity independent of the estrogen-ER pathway. These results suggest that AI may have some therapeutic value in EC; however, the hormonal microenvironment must be assessed prior to initiating therapy.

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Section: Discussionmentioning

confidence: 99%

Estrogen signaling ability in human endometrial cancer through the cancer-stromal interaction

Matsumoto

Yamaguchi

Seino

et al. 2008

Endocrine Related Cancer

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“…Aromatase is also expressed in endometrial cancer tissue, and aromatase inhibitors have been used to treat endometrial cancer (Bulun et al, 1994aRose et al, 2000;Burnett et al, 2004). The pathologic significance of local estrogen biosynthesis via aromatase expression in endometrial cancer tissue or the therapeutic value of aromatase inhibitors in its management, however, is not clear at the moment.…”

Section: Aromatase and Endometrial Cancermentioning

confidence: 99%

Regulation of Aromatase Expression in Estrogen-Responsive Breast and Uterine Disease: From Bench to Treatment

Bulun¹,

Lin²,

İmir³

et al. 2005

Pharmacol Rev

468

462

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“…Based on the findings these studies, letrozole could reduce endometrial thickness in patients with endometrial hyperplasia and in abnormal bleeding cases, it could stop the bleeding (18). Bernett and Colleagues also found that the combination of progestron and anastrozole might be more successful than progestin alone for the conservative management of well differentiated endometrial cancers in obese premenopausal women (19).Stefania and Hemendra reported a case of 58-year-old with recurrent endometrial carcinoma that was resistance to chemotherapy that was treated successfully with the aromatase inhibitore anastrozole (20). Among cases and literature review of electronic resources ,no article was seen on comparing letrozole and megestrol in treatment of endometrial hyperplasia.…”

Section: Discussionmentioning

confidence: 97%

Effect of Letrozole on Endometrial Histology in Patients with Disordered Proliferative Endometrium and Simple Hyperplasia

Gharabaghi¹,

Azadeh²,

Tabrizi³

et al. 2014

IJWHR

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Objectives: This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. Materials and Methods: In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group (n=46) and 40 mg of megestrol acetate daily in control group (n=46) for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. Results: After intervention in letrozole group, response to treatment was seen in 93% cases (including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases) and in megestrol group response to treatment was seen in 85% cases (including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases). The difference between two groups was not statistically significant (P=0.31). Conclusion: The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic.

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Anastrozole, an aromatase inhibitor, and medroxyprogesterone acetate therapy in premenopausal obese women with endometrial cancer: a report of two cases successfully treated without hysterectomy

Cited by 41 publications

References 8 publications

Estrogen signaling ability in human endometrial cancer through the cancer-stromal interaction

Estrogen signaling ability in human endometrial cancer through the cancer-stromal interaction

Regulation of Aromatase Expression in Estrogen-Responsive Breast and Uterine Disease: From Bench to Treatment

Effect of Letrozole on Endometrial Histology in Patients with Disordered Proliferative Endometrium and Simple Hyperplasia

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