Aromatase inhibitors with or without gonadotropin-releasing hormone analogue in metastatic male breast cancer: a case series

Zagouri, Flora; Sergentanis, Theodoros N.; Koutoulidis, Vassilis; Sparber, Cornelia; Steger, G.G.; Dubsky, Peter; Gc, Zografos; Ψαλτοπούλου, Θεοδώρα; Gnant, Michael; Dimopoulos, Meletios Α.; Bartsch, Rupert

doi:10.1038/bjc.2013.255

Cited by 49 publications

(29 citation statements)

References 31 publications

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“…In order to expand the data available for MMBC, and given the low prevalence of the disease, data collections were carried out by various institutions and cancer centers. In case reports and small retrospective studies, the successful use of chemotherapy [10,11,12,13] and hormonal treatment [14,15,16,17,18,19] in MMBC is reported. However, no data is available demonstrating an OS benefit for systemic treatment of MMBC.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic Male Breast Cancer: A Retrospective Cohort Analysis

Foerster¹,

Schroeder²,

Foerster³

et al. 2014

Breast Care

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Background: Metastasized male breast cancer (MMBC) is a rare disease. Given its low incidence, data regarding tumor biology, current treatment options, and survival rates are scarce. Patients and Methods: A chart review was performed of MMBC patients consecutively registered in regional cancer registries in Germany between 1995 and 2011. Tumor characteristics, treatment, and survival rates were documented and statistically evaluated. Results: 41 men with MMBC represented 25.6% of a total of 160 patients with MBC. 16 (39%) patients showed primary metastases, and 25 (61%) had recurrent metastases. Median survival from occurrence of metastasis was 32 months. Median overall survival (OS) was 68 months. 68.3% (n = 28) of the cohort received systemic therapy favoring endocrine therapy (n = 25, 61.9%). Prolonged metastatic OS (p = 0.02) was observed in patients having had a systemic treatment. Metastatic patients having received endocrine treatment showed significantly prolonged survival rates. Furthermore, patients receiving palliative chemotherapy had a significant survival benefit compared to those in whom chemotherapy was omitted. Conclusion: Our results suggest that systemic treatment in the form of both palliative chemotherapy and endocrine therapy improves outcome of MMBC. Therefore, it seems reasonable that treatment of MMBC should be based on the guidelines for female breast cancer.

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Section: Discussionmentioning

confidence: 99%

“…Tamoxifen is considered to be the first choice in the adjuvant setting [11]. However, no evidence exists whether AI should be given alone or combined with GnRH [19]. In addition, fulvestrant is reported in single case reports to be effective in MMBC [16].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Male Breast Cancer: A Retrospective Cohort Analysis

Foerster¹,

Schroeder²,

Foerster³

et al. 2014

Breast Care

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show abstract

“…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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“…For treating metastatic disease, AIs may be helpful, but should be only administered in combination with agents blocking the testicular production of steroid hormones, e.g. GNRH analogs (Zagouri et al 2013). …”

Section: Aromatase Inhibition In Menmentioning

confidence: 99%

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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Aromatase inhibitors with or without gonadotropin-releasing hormone analogue in metastatic male breast cancer: a case series

Cited by 49 publications

References 31 publications

Metastatic Male Breast Cancer: A Retrospective Cohort Analysis

Metastatic Male Breast Cancer: A Retrospective Cohort Analysis

Androgen receptor and antiandrogen therapy in male breast cancer

Aromatase inhibitors in the breast cancer clinic: focus on exemestane

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