Optimising endocrine therapy in postmenopausal women with advanced breast cancer

Hormone receptor-positive breast cancer is commonly treated with endocrine therapy; however, overtime cancer cells can develop endocrine resistance. This review aims to document combination therapy and sequential therapy in the use of endocrine agents and targeted agents. By conducting two systemati...

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Main Authors: Yau, Thomas Ho Lai, Cheung, Kwok-Leung
Format: Article
Published: Bioscientifica 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/51520/
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author Yau, Thomas Ho Lai
Cheung, Kwok-Leung
author_facet Yau, Thomas Ho Lai
Cheung, Kwok-Leung
author_sort Yau, Thomas Ho Lai
building Nottingham Research Data Repository
collection Online Access
description Hormone receptor-positive breast cancer is commonly treated with endocrine therapy; however, overtime cancer cells can develop endocrine resistance. This review aims to document combination therapy and sequential therapy in the use of endocrine agents and targeted agents. By conducting two systematic searches using 4 databases: Cochrane Library, MEDLINE, EMBASE, and Web of Science. A total of 26 studies that covered combination therapy were obtained and included for the review. 14 were phase III documenting combinations of mechanistic target of rapamycin (mTOR), phosphoinositide-3-kinase (PI3K), vascular endothelial growth factor receptor (VEGFR), human epidermal growth factor receptor 2 (HER2), and cyclin dependent kinase 4/6 (CDK4/6) inhibitors. The remaining studies were of phase II nature that reported combinations involving inhibitors in mTOR, endothelial growth factor receptor (EGFR), CDK4/6, and tyrosine kinase inhibitor (TKI). Interesting findings in inhibitor combinations involving; CDK4/6, mTOR and PI3K suggest clinical activity that can overcome endocrine resistance. On the other hand, there were 0 studies that covered sequential therapy. Overall findings showed that combination therapy improved treatment efficacy over monotherapy in postmenopausal patients with hormone-receptor positive advanced breast cancer. Inevitably, the benefits are accompanied with increased toxicity. To optimise endocrine therapy, further research into combinations and effective patient selection will need to be defined. Additionally, this review warrants future studies to explore sequential therapy.
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spelling nottingham-515202020-05-04T19:48:02Z https://eprints.nottingham.ac.uk/51520/ Optimising endocrine therapy in postmenopausal women with advanced breast cancer Yau, Thomas Ho Lai Cheung, Kwok-Leung Hormone receptor-positive breast cancer is commonly treated with endocrine therapy; however, overtime cancer cells can develop endocrine resistance. This review aims to document combination therapy and sequential therapy in the use of endocrine agents and targeted agents. By conducting two systematic searches using 4 databases: Cochrane Library, MEDLINE, EMBASE, and Web of Science. A total of 26 studies that covered combination therapy were obtained and included for the review. 14 were phase III documenting combinations of mechanistic target of rapamycin (mTOR), phosphoinositide-3-kinase (PI3K), vascular endothelial growth factor receptor (VEGFR), human epidermal growth factor receptor 2 (HER2), and cyclin dependent kinase 4/6 (CDK4/6) inhibitors. The remaining studies were of phase II nature that reported combinations involving inhibitors in mTOR, endothelial growth factor receptor (EGFR), CDK4/6, and tyrosine kinase inhibitor (TKI). Interesting findings in inhibitor combinations involving; CDK4/6, mTOR and PI3K suggest clinical activity that can overcome endocrine resistance. On the other hand, there were 0 studies that covered sequential therapy. Overall findings showed that combination therapy improved treatment efficacy over monotherapy in postmenopausal patients with hormone-receptor positive advanced breast cancer. Inevitably, the benefits are accompanied with increased toxicity. To optimise endocrine therapy, further research into combinations and effective patient selection will need to be defined. Additionally, this review warrants future studies to explore sequential therapy. Bioscientifica 2018-07-30 Article PeerReviewed Yau, Thomas Ho Lai and Cheung, Kwok-Leung (2018) Optimising endocrine therapy in postmenopausal women with advanced breast cancer. Endocrine-Related Cancer, 25 (7). pp. 705-721. ISSN 1479-6821 Breast cancer Hormone-receptor positive Advanced Postmenopausal Endocrine Therapy Combination Sequential https://erc.bioscientifica.com/view/journals/erc/25/7/ERC-18-0021.xml doi:10.1530/ERC-18-0021 doi:10.1530/ERC-18-0021
spellingShingle Breast cancer
Hormone-receptor positive
Advanced
Postmenopausal
Endocrine Therapy
Combination
Sequential
Yau, Thomas Ho Lai
Cheung, Kwok-Leung
Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title_full Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title_fullStr Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title_full_unstemmed Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title_short Optimising endocrine therapy in postmenopausal women with advanced breast cancer
title_sort optimising endocrine therapy in postmenopausal women with advanced breast cancer
topic Breast cancer
Hormone-receptor positive
Advanced
Postmenopausal
Endocrine Therapy
Combination
Sequential
url https://eprints.nottingham.ac.uk/51520/
https://eprints.nottingham.ac.uk/51520/
https://eprints.nottingham.ac.uk/51520/